There is compelling evidence that people with mental illness die earlier than the general population and are at higher risk of physical illness.
We know that long term physical health conditions can lead to people suffering more from poor mental health. As daunting as these facts are we have made little, if any, progress in improving life expectancy in this vulnerable group. This is not because of any inertia on our part. It's due to a number of inter-related complex reasons which include physical, social and psychological causes, particularly health behaviours, the obvious ones being smoking and physical inactivity.
Work is already underway at all levels; policy, strategic, organisational and individual. It is critical that we all direct our efforts to help reduce these health inequalities, improve the physical healthcare of people with mental illness and reduce avoidable deaths.
Mental health nurses are crucial to this process. It is important they do not miss opportunities to promote health improvement by using every contact they have to help people improve their physical health and provide advice to encourage them to adopt health-promoting behaviours such as stopping smoking, eating and drinking healthily and becoming more active. The person-centred nature of the therapeutic relationship between mental health nurses and people in their care means that they are ideally placed to help those with the greatest need to make lifestyle changes and access healthcare interventions, including health and dental checks.
Across the country many mental health nurses are already making a real difference to the physical health of people with mental illness, but we know this is not happening everywhere. Peoples’ physical health problems are often not diagnosed or managed well, and lifestyle factors, which negatively affect physical health are not always addressed soon enough. Missing the opportunities to address these issues can result in people with mental illness suffering more and in some cases dying sooner than one might expect. We want to reduce this unwarranted variation and make improvements across mental health nursing, encourage all nurses to take positive action to improve the physical health of people with mental health problems and maximise the impact of their interventions.
We have developed a national resource ‘Improving the physical health of people with mental health problems: Actions for mental health nurses’, which recognises the inter-relationship between physical health and mental health. The resource provides evidence-based information about ways in which nurses can improve the physical health of people with mental health problems by tackling some of the key risk factors. It builds on work to ensure parity of esteem, giving equal attention to the physical health of people with mental health problems as is given to the general population. By providing the focused support highlighted in this resource, mental health nurses can help people with mental health problems navigate their way through the frequently complex health and social care system. They can ensure that people can access relevant health checks, screening and care that they need, when they need it, and support them to improve their self-care, so that they can have healthier lifestyles.
The resource complements other programmes of work underway to address the physical health needs of people with mental health problems, for example, NHS England have produced a practical toolkit for mental health trusts and commissioners, designed to help them improve the physical health of patients with serious mental illness.
Our aspiration is to put healthcare for people living with mental health problems on an equal footing with people with physical problems. This means that people with mental health problems should be supported to live healthy lives, and should be enabled to make real progress towards bringing their life expectancy in line with the rest of the population.
I'd be interested in hearing your views on this issue and any feedback you have on the resources I've referred to. Please do comment below.