In the Journals

Commission offers ways to improve physical health of people with mental illness

Image of Joseph Firth 2019
Joseph Firth

The Lancet Psychiatry Commission, a global taskforce of mental health experts, presented key targets, emerging strategies and recommendations for improving physical health outcomes in people with mental illness.

To protect the physical health of people with mental illness, the commission highlighted the importance of early intervention during the initial stages of illness and multidisciplinary lifestyle treatments.

"The disparities in physical health outcomes for people with mental illness are currently regarded as a human rights scandal,” Joseph Firth, PhD, senior research fellow at NICM Health Research Institute, Western Sydney University, Australia, and chair of the commission, said in a press release.

Based on data from nearly 100 systematic reviews and meta-analyses on the prevalence of physical comorbidities among people with mental illness, the investigators reported that about 70% of the research focused on cardiometabolic diseases and that mental illnesses were linked to an increased risk for obesity, diabetes, and cardiovascular diseases compared to the general population. Furthermore, these comorbidities affect individuals with mental disorders across the lifespan.

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“Patients with serious mental illness are two to three times as likely to have obesity, diabetes and cardiovascular diseases — which impact on quality of life and recovery, while contributing towards a 20-year gap in life expectancy currently experienced by this underserved population,” Firth said. “Clearly, protecting the physical health of people with mental illness should be considered an international priority for reducing the personal, social and economic burden of these conditions.”

The commission found that risk factors included smoking, excessive drinking, sleep disturbance, physical inactivity and dietary risks across a broad range of diagnoses; however, more research is needed to determine the prevalence for risk factors of infectious diseases and physical multimorbidity in mental illness, especially in low-income and middle-income settings.

The commission recommended that lifestyle interventions in mental health care focus on prevention and adopt the core principles of the Diabetes Prevention Program into interventions for people with mental illness. These interventions should provide multidisciplinary lifestyle treatments that target a range of health behaviors, like physical activity and healthy eating. Early lifestyle interventions should be available to protect metabolic health from when the illness first presents, they wrote.

They also emphasized the value of developing integrated care models to manage physical and mental multimorbidity, particularly in low- to middle-income settings where health inequalities for people with mental disorders are greatest.

"Our commission found that although there is increasing attention towards the lifestyle risk factors in mental illness, there is still a widespread lack of implementation of evidence-based lifestyle interventions for these populations,” Simon Rosenbaum, PhD, from the UNSW Sydney School of Psychiatry, said in the press release. "We must take 'what works' from effective interventions for improving physical activity, diet and cardiovascular health in the general population and find innovative and cost-effective ways for making these interventions a standard part of care for those treated for mental illness." – by Savannah Demko

Disclosures: Firth and Rosenbaum report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Image of Joseph Firth 2019
Joseph Firth

The Lancet Psychiatry Commission, a global taskforce of mental health experts, presented key targets, emerging strategies and recommendations for improving physical health outcomes in people with mental illness.

To protect the physical health of people with mental illness, the commission highlighted the importance of early intervention during the initial stages of illness and multidisciplinary lifestyle treatments.

"The disparities in physical health outcomes for people with mental illness are currently regarded as a human rights scandal,” Joseph Firth, PhD, senior research fellow at NICM Health Research Institute, Western Sydney University, Australia, and chair of the commission, said in a press release.

Based on data from nearly 100 systematic reviews and meta-analyses on the prevalence of physical comorbidities among people with mental illness, the investigators reported that about 70% of the research focused on cardiometabolic diseases and that mental illnesses were linked to an increased risk for obesity, diabetes, and cardiovascular diseases compared to the general population. Furthermore, these comorbidities affect individuals with mental disorders across the lifespan.

Woman Running 
Source: Shutterstock.com

“Patients with serious mental illness are two to three times as likely to have obesity, diabetes and cardiovascular diseases — which impact on quality of life and recovery, while contributing towards a 20-year gap in life expectancy currently experienced by this underserved population,” Firth said. “Clearly, protecting the physical health of people with mental illness should be considered an international priority for reducing the personal, social and economic burden of these conditions.”

The commission found that risk factors included smoking, excessive drinking, sleep disturbance, physical inactivity and dietary risks across a broad range of diagnoses; however, more research is needed to determine the prevalence for risk factors of infectious diseases and physical multimorbidity in mental illness, especially in low-income and middle-income settings.

The commission recommended that lifestyle interventions in mental health care focus on prevention and adopt the core principles of the Diabetes Prevention Program into interventions for people with mental illness. These interventions should provide multidisciplinary lifestyle treatments that target a range of health behaviors, like physical activity and healthy eating. Early lifestyle interventions should be available to protect metabolic health from when the illness first presents, they wrote.

They also emphasized the value of developing integrated care models to manage physical and mental multimorbidity, particularly in low- to middle-income settings where health inequalities for people with mental disorders are greatest.

"Our commission found that although there is increasing attention towards the lifestyle risk factors in mental illness, there is still a widespread lack of implementation of evidence-based lifestyle interventions for these populations,” Simon Rosenbaum, PhD, from the UNSW Sydney School of Psychiatry, said in the press release. "We must take 'what works' from effective interventions for improving physical activity, diet and cardiovascular health in the general population and find innovative and cost-effective ways for making these interventions a standard part of care for those treated for mental illness." – by Savannah Demko

Disclosures: Firth and Rosenbaum report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.