In general, people with mental disorders tend to die decades earlier than the general population, mostly as a result of preventable and treatable chronic conditions, such as cancer. Individual lifestyle factors, such as smoking, obesity, or not seeing a doctor, are often cited as the major factors contributing to cancer risk among persons with mental illness.
Now, a new report funded by the National Institutes of Health and the American Cancer Society suggests that factors within the health care system and society may play just as critical a role in this phenomenon as a person’s individual lifestyle factors.
Approaches that focus solely on “individual-level interventions have been criticized by some as ‘blaming the victim’ and can be particularly problematic for marginalized and stigmatized populations, such as those with experiences of mental illness, because they often fail to acknowledge the overwhelming environmental and societal barriers to good health,” write the authors.
In the new report, researchers reviewed the literature on cancer prevention, screening, and treatment for those with mental illness. They found that although multiple interventions are being developed and tested to address tobacco dependence and obesity in this group, the evidence for effectiveness remains minimal, and essentially all interventions focus on the individual level.
The review provides a summary of key recommendations for medical personnel to improve cancer prevention screening and treatment in people with mental illness, including:
- increase awareness of cancer screening in mental health service providers;
- provide a community health worker or peer counselor to help patients navigate the screening and treatment process;
- consciously avoid the tendency to attribute physical symptoms that may indicate cancer to the patient’s mental illness;
- involve staff from community-based social support, who often have long-term relationships with patients, early in the diagnostic and treatment process;
- engage people with mental illness in end-of-life treatment decisions.
“We hope this review draws attention to the limitations of the current health care system to improve cancer control in this marginalized population,” said Lara C. Weinstein, M.D., M.P.H., of Thomas Jefferson University, Philadelphia.
“Improving cancer prevention and control efforts in people with mental illness will require fully integrating medical and behavioral health care in settings that commonly provide services to this population,” she said. These include community mental health care sites, community service centers, and supportive housing.
In this way, Weinstein said, “Health interventions are brought to people’s doorsteps, reducing the access and engagement barriers that are contributing to existing disparities.”
Estimates indicate that nearly one in five adults (18.6 percent) suffered some form of any mental illness in the last year, and nearly 10 million U.S. adults (4.1percent of the population) had a serious mental illness (such as schizophrenia or bipolar disorder) in the past year.
The report is published in CA: A Cancer Journal for Clinicians.
Source: American Cancer Society