Lifesaving strategies for people experiencing
People with mental illness are very concerned about their physical health. They need more than just being told every now and then by their healthcare providers that they should exercise, lose weight, stop smoking, eat more vegetables and so forth. While raising the topic is one important step, they need real support and encouragement that they can apply each day of their lives, and follow-up.
Professor Sharon Lawn, Executive Director, Lived Experience Australia
The statistics tell us:
Over 30 people experiencing mental ill-health die every day from preventable physical illnesses, compared with 8 who die by suicide (reference)
Eighty percent of people living with serious mental ill-health conditions live with a least one co-existing chronic physical health condition (reference)
On average, people living with mental ill-health die 20 years earlier than the rest of the population (reference)
Prevention, screening, early identification and treatments are vital
"Please do something about all of this. It is disgraceful that I have to see myself and so many people fall apart physically and mentally because the system is completely messed up."
Lived Experience Survey Respondent
New Research provides answers
In 2021, peak advocacy organisation Lived Experience Australia, along with Equally Well Australia, conducted research to understand the level of support and focus on the physical health needs of people living with mental ill-health from the health and mental health professionals they accessed. The report produced from this research presents a national collective voice of consumers’ and carers’ experiences.
Consumers and Carers in this survey told us
Almost all respondents had accessed a health professional in the previous 12-months
The majority of mental health professionals seen had not enquired about their physical health
Their concerns about physical health or medication side-effects were not taken seriously nearly half of the time
GPs are more likely to ask about physical health but may still not cover smoking or cancer screenings
Carers are often not included in care planning and decision-making for the person they support
Most cannot afford to access health professionals as often as they need to.
Only 1 out of every 5 consumers were asked about their physical health by their mental health provider
Only 1 out of 4 carers were asked about the physical health of the person they support by the mental health provider
"Most of the premature deaths of people living with mental illness are preventable through basic physical health screening and treatments. But our results show most of these opportunities to identify and address the physical health needs of consumers are being missed. This is at tremendous cost to consumers and the Australian health system generally.”
Russell Roberts, Researcher, Equally Well Australia
Seeing the 'whole' person is the answer
Our colleagues at the Mental Health Coalition of South Australia said it beautifully in this series of videos 'We have to get our heads around mental health'. People are so much more than their mental ill-health diagnosis, and all of us will benefit from seeing them that way. Mental health outcomes will improve when physical health is included in care.
This is not new news
In 2016, the National Mental Health Commission Equally Well Consensus Statement (page 18) provided this as an action towards Improved Quality of Health Care:
All mental health services should include documented physical health care checks as part of the routine care of people living with mental illness:
Health assessments should be part of an integrated physical and mental health care plan developed together with the person living with mental illness, their family, carers and supporters.
It should take the person’s strengths, and the extended support available through family, friends, carers and peers, into account.
Assessments should consider the risk of developing conditions such as obesity, cardiovascular disease, respiratory illness, osteoporosis, diabetes and metabolic syndrome.
“This research shows that despite national guidelines and priorities, many allied and mental health professionals only focus on their client’s psychiatric diagnosis. This means that, not only are the early signs of treatable and preventable disease missed, it also fails to recognise that good physical health is fundamental to good mental health and overall wellbeing.
That said, we are not expecting mental health and allied health professionals to be medical experts. But as a part of a health system, it is important they ask and assist in connecting their clients to medical professionals as appropriate.
Russell Roberts, Researcher, Equally Well Australia
It's time to start another conversation
RUOK started a mental health conversation. It's time to take it a step further to a whole-being conversation.
Health professionals (including mental health professionals) seeking the best outcomes for their clients as whole beings need guidance, training and resources for further understanding of mental and physical health needs.
Carers, family members, and mental health allies can also be part of this conversation.
Ask - about whether physical health checks and screenings have taken place, have they tried to quit smoking, had vaccinations, etc.
Advise - the health benefits of having these checks, screenings, etc.
Assist - the person to find the right information, contacts, bookings, or appointments
Advocate - and speak up for them if things are not right
Key findings from this research
Mental health professionals and physical health
Only 55% of respondents reported that mental health professionals showed an interest outside of their mental health diagnosis - for example: social connectedness, community participation, physical health
Only 52% of respondence reported that mental health professionals took their concerns about physical health seriously
Only 53% of respondents reported that mental health professionals paid attention to their concerns about physical side effects of medications
Consumer and Carer inclusion in care planning and delivery
38% of consumers indicated that their greatest support for their physical health was their carer or family member
49% of consumers reported that mental health professionals had included their family or carer support person in their discussions.
Only 33% of carer respondents indicated that mental health professionals included them in the physical care of the person they support.
Affordability and Access to Mental and Physical Health Care
Consumers surveyed cannot afford to see a mental health professional when and as often as they need to
Consumers surveyed do not have enough access to allied health professionals to support their physical health
Consumers preferred receiving medical information from medical professionals, however 80% of them also turn to Google for information about physical health.
Recommendations from this report
All health professionals should regularly ask about health screening for cancer, heart disease, lung disease and vaccination status, and be ready and equipped to support consumers to access the necessary screening or treatments.
Further training, resources and guidance for mental health professionals to focus on a consumer’s holistic healthcare including attention to consumers’ physical health.
Further training for health professionals regarding involving consumers and carers in decision-making about medications and responding to concerns about their physical and mental health care.
All health professionals should routinely ask consumers about smoking, and be prepared to provide advice and assistance should the consumer be interested in quitting.
Health information about chronic health conditions must be shared between GPs and others who are involved in the care of the consumer, with consent from the consumer.
Greater engagement with and involvement of carers to support a ‘whole of health’ approach to mental health care.
Establishing a central online repository providing trusted resources specifically aimed at supporting the physical health needs of mental health consumers that is available to consumers, carers, and service providers. This should be co-designed with consumers, carers and service providers.
Background to this Research Report
Lived Experience Australia (LEA), a leading research and advocacy organisation for mental health services, in partnership with Equally Well (EW) has undertaken this survey with mental health consumers and carers to gather feedback on their experiences of accessing a range of allied and mental health services and the level of attention to and support for their physical health care needs.
The survey was open for 4 weeks between October and November 2021. A copy of survey questions is available here.
The survey focused on the extent of attention to both their physical and mental health when accessing various health professionals such as general practitioners, psychiatrists, pharmacists, allied health and mental health professionals. Carer respondents were asked the same questions from the perspective of a family member/carer providing support to a person with mental ill-health.
“It’s the people who use these services who are in the best position to talk about what works well and also what is needed” says Sharon Lawn, LEA’s Executive Director.
Lived Experience Australia is happy to conduct interviews, or provide any additional information you may need for articles or news items.
Media enquiries to Professor Sharon Lawn, Chair and Executive Director
Phone: 0459 098 772
Alternatively, please contact the Lived Experience Australia national secretariat office on 1300 620 042 or contact us through this page.
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