Health system failing to provide proper physical health care to people with mental illness, experts warn

By Shannon Jenkins

Thursday August 26, 2021

Sixty health experts have called for the federal government to establish a mental health clinical quality registry.
Sixty health experts have called for the federal government to establish a mental health clinical quality registry. (andranik123/Adobe)

A new report developed by 60 health experts has called for the federal government to establish a mental health clinical quality registry that measures progress towards parity in life expectancy for people with serious mental illness.

The roadmap, launched on Thursday, has recommended major changes to primary healthcare services to stop people with serious mental illnesses from dying between 14 and 23 years earlier than other Australians.

The report noted that 80% of people with serious mental illness die prematurely of manageable and preventable chronic physical health conditions, including cardiovascular disease and respiratory disease.

“Mental illnesses in interaction with other chronic diseases (comorbidities) represent one of the biggest challenges to public health systems in Australia,” it said.

“Current health care services are simply and starkly failing to provide adequate physical health care for people with serious mental illness.”

The roadmap has been developed by the Australian Health Policy Collaboration at Victoria University’s Mitchell Institute and Equally Well Australia, in partnership with health professionals, and mental health consumers and carers.

Recommendations made in the report include the establishment of a national Office for Quality in Physical and Mental Healthcare Outcomes, as well as a National Mental Health Clinical Quality Registry. The registry would support and monitor improvements in life expectancy for people with serious mental illnesses.

Other recommendations include the removal of financial barriers for medication, including cardiovascular risk reduction medication and nicotine patches, and the development of national clinical guidelines for shared care.

The establishment of a community mental health nurse workforce, ‘nurse navigators’, has also been recommended. These nurses would be embedded in GP clinics to support the health care needs of people with complex biopsychosocial needs.

AHPC lead Professor Rosemary Calder said change was needed to address the ‘shocking reality’ that people with severe mental illness die up to 23 years earlier than other Australians.

“Our current health system is largely designed and structured to treat health conditions separately and health professionals often prioritise mental health illness over physical health. There is also a persistent element of bias – with mental illness sometimes seen to be the explanation of other illnesses or conditions,” she said.

“We need better health system arrangements that prioritise and support both the physical and mental health of people at the same time.”

The roadmap’s recommendations would help more than 470,000 Australians with a serious mental illness live longer and healthier lives, Calder said.

“Delivering a shared care model of health care will ensure the whole person is treated and physical healthcare is given the priority it should command alongside mental healthcare,” she said.

University of Melbourne Professor of Psychiatry Malcolm Hopwood said he was ‘horrified’ that his next patient with a major mental illness could die up to 20 years younger than other Australians.

“It is simply unacceptable,” he said.

“The suite of measures in this roadmap offers an evidence-based way forward and demands government and healthcare sector support.”


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