Parity of esteem between mental and physical health services – along with greater integration of the two – is crucial if the statistic that people with serious mental illnesses die up to 20 years younger than their peers who do not have a mental illness,is to be challenged.
Research published in the past week has again highlighted that people with serious and enduring mental health conditions die on average 10-20 years younger than their peers, often of physical conditions that could be prevented, such as heart disease.
This is not a revelation, and there are numerous reports that have come before – such as Rethink Mental Illness’ Lethal Discrimination from 2013 – saying much the same thing: People with enduring mental illness such as schizophrenia and bipolar die younger than average, often because they don’t get the physical healthcare they need, when they need it.
In the report by Oxford University, it is pointed out that while 1 in 4 people experience a mental health issue every year, this has been much less of a public health priority over the years than smoking, which takes fewer years of life expectancy (8-10 years) and is something only 1 in 5 people do.
It neatly demonstrates how mental health has lagged behind physical health in terms of public health priorities – and still does in many ways, despite the progress that has been made in recent years. The government’s goal of ‘parity of esteem’ for mental and physical health is still only a pipe-dream.
Rethink Mental Illness’ new chief executive, Mark Winstanley, pulled no punches in reaction to this, calling it a “scandal” that people with mental ill health die so young. It is hard to disagree: it has certainly gone on for far too long.
But while the issues are well known, so are the ways to rectify it: better physical healthcare for people with mental health issues, along with greater integration of physical and mental healthcare.
This is easier said than done, of course, but nevertheless the current move towards integration has to be quickened. It has to be a priority from government downwards. The commitment to parity of esteem is welcome, but it needs to become reality, and to do that will take funding. Mental health services are still chronically underfunded and more money is needed – there is only so much that shuffling the budgets and ‘efficiency savings’ can do.
Local commissioners need to prioritise services that support the whole person – mentally and physically. While putting them in place might not be an ‘easy’ option, it is something that could bring major savings down the line as conditions are treated at the right time and not when a crisis occurs when it is much more difficult – and expensive – to address.
More public health initiatives geared to mental health are also needed. Those aimed at smoking have cut the number of people who smoke, which is starting to impact on the number of deaths from related conditions. With the same will, and resources, there is no reason why the same cannot happen for mental health.