Britians first medical schoolThe British Medical Association (BMA) has called for urgent action to address the inequalities in healthcare facing people with learning disabilities or mental ill health.

The BMA’s report, Recognising the importance of physical health and intellectual disability — achieving parity of outcomes, calls for a range of measures to address the fact men with mental health problems die, on average, 20 years earlier than those without; women with mental health problems die 15 year earlier. Similar patterns of premature mortality are seen among adults with a learning disability.

The BMA calls for a range of measures including:
• All mental health trusts to appoint a liaison physician in psychiatric wards to support the physical health needs of patients
• A liaison psychiatry service and intellectual disability liaison service to be made available in all hospitals
• Improved training for trainees and doctors in how to deal appropriately with people with mental illness and people with intellectual disability, and how to adapt their care to achieve good outcomes
• Better integration of intellectual disability, mental health and physical healthcare to ensure there are clear pathways of care, and allocation of responsibility
• The establishment of a national learning disability mortality review.

'Scandalous disparity'
BMA board of science chair Baroness Sheila Hollins said: “There is a scandalous disparity in the health outcomes for people with mental health problems and intellectual disability compared with those without.

“While people with mental health problems do not have parity with physical health, the case is even worse for those with intellectual disabilities. This is a vital issue for doctors to be aware of as they need to be the voice speaking up for these vulnerable patients, to ensure they get the best possible care — free from discrimination and a lack of aspiration.

“There would be an outcry if patients with a physical illness were denied treatment or care due to cuts in funding, yet this is what we are seeing for those patients suffering from mental illness.

“In order to address this problem it is vital that we stop emphasising one or the other, and ensure that equal value is placed on both mental and physical health, particularly for the most vulnerable members of society.”

Welcome report
The BMA’s report has been welcomed by mental health and learning disability charities. Mark Winstanley, CEO of Rethink Mental Illness, welcomed its call for better physical health support for people with mental illness: “The Government has promised to put mental health on a par with physical health in the NHS, but that’s far from a reality as things stand. It’s absolutely scandalous that people with severe mental illness are at risk of dying 20 years younger than average, because of preventable physical conditions. This urgently needs to change.

“But if the Government really is serious about making mental health equal to physical health, then it must also address the chronic lack of funding for mental health services in this country. Mental health accounts for 23% of the disease burden in England, but gets just 13% of the budget.

“Even worse, mental health services now face being cut by 20% more than acute hospital services, which means that more and more people with mental illness will miss out on the treatment they need to get better. Until this basic inequality is resolved, people with mental illness will continue to get a raw deal.”

Further reading: Experts call for 'parity of esteem' to be higher on the healthcare agenda

Jan Tregelles, chief executive of Mencap, added: “It is unacceptable that people with a learning disability die significantly earlier than the general population because of unequal access to healthcare. Too often, physical health needs are not picked up, and signs are not explored or taken seriously, because people only see the ‘learning disability’. This is despite the fact that people with a learning disability are more likely to have other health issues, such as obesity and respiratory problems.

“A scandal of avoidable deaths on the scale of Mid-Staffordshire takes place every single year for people with a learning disability in the NHS. These deaths, caused by poor care and delays in diagnosis and treatment, highlight the scale of discrimination faced by patients with a learning disability.

“This is a problem with a solution. We support the report’s call for a fully-funded national body to monitor and investigate the deaths of people with a learning disability, so we can learn from mistakes and stop this tragic waste of life.

“Everyday that passes another 3 people with a learning disability could have died in the NHS. The government must act now and provide details on how they plan to end these tragedies.”