Physical Health Issues In Mental Health Clients: Causes and Solutions Assignment Sample

Introduction: Strategies to Address Physical Health Issues in Mental Health Clients

It is imperative to prioritise and address the physical health of mental illness clients for comprehensive and effective treatment. Research has demonstrated that individuals living with mental illnesses have a significantly shorter lifespan compared to the general population, with factors at the individual, healthcare system, and societal levels contributing to this health inequality. This disparity is concerning and requires action across multiple domains to improve longevity and quality of life for those with mental illness. This analysis will discuss the various reasons for poor physical health outcomes in this group, as well as evidence-based strategies that could help close this life expectancy gap if implemented widely.

Evidence of Life Expectancy Differences

Mental health and physical health are closely interconnected, with each domain impacting the other bi-directionally. Comorbidity refers to the high prevalence of co-occurring chronic physical illnesses among those with mental disorders and vice versa. This demonstrates the mind-body connection, as physical and mental health have overlapping determinants and biological pathways that influence susceptibility to disease. According to Walker et al. (2015), "People with mental disorders experience a high burden of mortality at the individual and population levels" (p. 9). The study found that "The pooled RR for all-cause mortality was 2.22 times higher than the general population or people without mental disorders" (p. 15). The study found that "Inpatients had significantly higher mortality rates compared with samples with outpatients and with community-based samples" (Walker. et al., 2015., p. 8).

Tiihonen et al. (2009, p. 2) found that “the difference in life expectancy was greater at age 20 years than it was at age 40 years, implying that the mortality gap is largely attributable to deaths at an early age, even though the mean age of the cohort was 51 years”. Research shows that consumers of mental health services experience poor physical health compared to the general population, leading to increased rates of chronic illness and premature mortality (Tabvuma et al., 2023). As Tabvuma et al. (2023) found in their recent integrative review, despite increased policy and research efforts to address the physical health needs of mental health consumers, there has been limited translation of recommendations into practice. The authors argue that this 'implementation gap' may relate to the lack of literature capturing consumer perspectives and experiences with physical healthcare and intervention.

The 2020-2022 National Survey found that 42.9% of Australians had experienced a mental disorder in their lifetime, with 21.5% having a 12-month disorder, most commonly being anxiety (17.2%). Younger age groups aged 16-24 and 16-34 had higher prevalence at 38.8% and 22.9% respectively (ABS, 2023). The 2020-2022 “National Health Survey” also reported that life expectancy in Australia was 81.2 years for males and 85.3 years for females, with the highest and lowest in the ACT and NT, respectively (ABS, 2023). Healthy life expectancy has increased over three decades but remains lower than total life expectancy. These statistics demonstrate the magnitude of poor mental health outcomes and reduced life expectancy faced by Australians.

Cancer and mental or behavioural disorders are also placed highly, each affecting over 4 million Australians. Musculoskeletal conditions like back problems and arthritis had widespread occurrence rates above 3 million people. At the other end of the spectrum, diseases like kidney disease and osteoporosis demonstrated comparatively lower prevalence, impacting hundreds of thousands rather than millions (Statista.com, 2024). Additionally, around 1 in 5 adults (19% or 4.2 million people) were estimated to be living with a diagnosed mental or behavioural health disorder.

Research studies show a high prevalence of chronic physical illnesses among those with severe mental illness (SMI), contributing to their shortened lifespan (De Hert et al., 2011; Hayes et al., 2017; Laursen et al., 2014; Scott & Happell, 2011). For example, one study found that cardiovascular disease accounts for up to 53% of excess deaths in people with SMI (Scott & Happell, 2011).

Psychotropic medications used to treat mental illness can have metabolic side effects leading to obesity and other issues that increase the risk of cardiovascular disease (Bak et al., 2014). A review found that some antipsychotics can cause weight gain of over 7 kg in under 12 weeks (Nationalelfservice.net, 2024). Barriers to accessing physical healthcare like cost, prioritization of mental healthcare, and stigma hinder those with mental illness from receiving adequate care (Happell et al., 2012; Scott & Happell, 2011). One study notes stigma as the most significant patient-related barrier (Happell et al., 2012). There is often a lack of awareness and prioritization of physical health within mental health services, worsening outcomes (Happell et al., 2012; Scott & Happell, 2011). One analysis found only 29% of mental health treatment plans addressed cardiometabolic health risks (Scott & Happell, 2011).

Factors Contributing to Poor Physical Health

Genetics play an important role in predisposing individuals to mental and physical health conditions. The study by Cerdá et al. (2010) highlights the strong influence of genetic factors influencing comorbidity between major depression and anxiety disorders. For example, family history and genetic vulnerability are risk factors for diseases like cardiovascular disease, diabetes, and autoimmune disorders, which tend to be more prevalent in people with severe mental illnesses such as schizophrenia and bipolar disorder. There are likely overlapping genetic determinants and shared biological pathways between psychiatric and physical illnesses that increase susceptibility.

Environmental factors

Socioeconomic disadvantage impacts health and longevity (Poulton et al., 2002). Those from lower socioeconomic backgrounds tend to have reduced access to healthcare services, nutritious food, safe housing, and health-promoting resources (Macintyre, 2007). Unemployment and financial insecurity also lead to increased psychological stress, which negatively impacts physical health. Due to both the direct symptoms and stigma around mental illness, patients often struggle to attain higher levels of education or skilled work, perpetuating socioeconomic disadvantage. This clustering of adverse environmental exposures and limited access to healthcare likely accelerates disease progression.

Cultural Factors

An individual's cultural upbringing, which includes family attitudes, beliefs, and practices around health, illness and help-seeking, shapes health behaviours and outcomes. For example, certain cultural groups may have different levels of mental health literacy, wariness or mistrust of medical systems due to past discrimination, or traditional healing practices that impact treatment adherence. The impact of culture on mental health is further underscored by the influence of cultural diversity on perceptions of health and illness, coping styles, and treatment-seeking patterns (Gopalakrishnan, 2015).

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Social Factors

Several social factors contribute to the physical health disparities seen in mental illness. Stigma and discrimination in healthcare settings are pervasive as barriers to help-seeking and quality treatment (Progovac et al., 2020). People with mental illness report negative attitudes among staff, inadequate examination, and dismissal of physical symptoms as psychosomatic, leading to missed diagnoses. Additionally, unemployment rates of up to 90% in schizophrenia reduce financial means to access healthcare and medications (Lin et al., 2022). Unstable housing situations every day in mental illness also create barriers to attending appointments and managing health.

Role of Nutrition, Exercise, and Pharmacological Treatments

Nutrition

Prenatal nutrition

Poor nutrition is a modifiable risk factor contributing to adverse physical health outcomes in mental illness (Owen & Corfe, 2017). The diets of those with mental health conditions are often nutritionally inadequate due to financial constraints, low motivation for self-care, and lack of knowledge about nutrition (Barre et al., 2011). Consumption of high-fat, high-sugar processed foods and takeaways is increased, while intake of “nutrient-dense foods such as fruits, vegetables, whole grains and lean proteins” is reduced (Steele et al., 2020). This eating pattern negatively impacts weight, glucose control, and cardiovascular health. Evidence supports nutritional education delivered in group settings as an effective intervention, resulting in increased consumption of healthy foods (Barker et al., 2018). Research shows that poor nutrition can negatively impact mental health. Diets high in processed and ultra-processed foods correlate with increased risk for conditions like depression and anxiety (Liu et al., 2022; Marteinsdottir et al., 2022). Specific nutritional deficiencies also link to adverse mental health symptoms (Rucklidge & Kaplan, 2022). Alternatively, healthy diets like the Mediterranean diet demonstrate protective effects against mental health issues (Carvalho et al., 2022). Maternal prenatal nutrition even influences child cognitive outcomes (Veena et al., 2016). These findings highlight nutrition as a modifiable risk factor for supporting mental wellbeing. Implementing interventions to improve nutrition presents opportunities for enhancing population-level mental health.

Exercise-Based Interventions

Lack of physical activity is another modifiable risk factor exacerbating the poor physical health of people with mental illness. Sedentary behaviours are common due to motivational deficits, fatigue, psychotropic medication side effects, and lack of knowledge about risks (Schuch & Vancampfort, 2021). However, evidence demonstrates that exercise can significantly improve physical and mental health in this population. Aerobic and resistance training programs tailored to individual capacity and health goals are known to reduce cardiometabolic risk factors, decrease symptoms of depression and anxiety, and improve quality of life (Smith & Merwin, 2021).

Closing the Gap

Physical health disparities in people with mental illness are well-documented, with a 10–25-year reduced life expectancy compared to the general population. People with mental illness have high rates of preventable chronic physical illnesses like cardiovascular disease, diabetes, respiratory conditions, and musculoskeletal disorders. These comorbidities interact bidirectionally with mental health. Multiple factors drive this health inequality at the individual, health system, and societal levels.

Individual risks include greater exposure to modifiable lifestyle risks like smoking, substance use, poor nutrition, and low physical activity (Happell et al., 2016). Side effects of psychiatric medications also contribute. For example, some antipsychotics can cause rapid weight gain, diabetes, and metabolic issues. Managing polypharmacy interactions poses further challenges. Systemic barriers to healthcare access include financial limitations, prioritizing mental over physical health, stigma and discrimination in medical settings, and lack of care coordination between mental health and primary care.

Social determinants like socioeconomic disadvantage, unemployment, inadequate housing, and intergenerational trauma and stress create additional risks. Stigma and exclusion from community life exacerbate barriers to wellbeing. Evidence-based strategies to address these factors include integrated models of mental and physical healthcare, routine metabolic monitoring, lifestyle interventions, community inclusion programs, and policy changes. Integrated care models allow holistic screening, shared treatment planning, and coordinated responses across disciplines. This facilitates early intervention for emerging physical and mental health issues. Dedicated funding structures enabling collaborative practice are needed.

Clinician education programs should address knowledge gaps in physical health, adverse medication effects, and managing complexity (Alcaraz et al., 2020). Routine screening and preventative advice on diet, exercise, smoking, and substance use is vital. Where risks emerge, developing wellbeing plans addressing psychosocial issues could improve engagement. Exercise and nutrition programs tailored to individual needs and preferences show potential for lowering cardiovascular risk factors and symptoms of anxiety and depression. Group-based interventions providing social support may optimize access and mental health benefits.

Community initiatives promoting social inclusion, physical activity and healthy eating counteract stigma and support recovery (Litwiller et al., 2017). Public awareness campaigns foster greater understanding and reduce discrimination. Policy and legislative changes mandating equal priority for physical health and enabling integrated care models can drive reform. A comprehensive approach tackling education, employment, housing, and environmental risks is required to address socioeconomic determinants and close the mortality gap. Thus, concerted efforts across health systems, communities, and governments to implement evidence-based integrated care models, clinician training, routine screening, lifestyle interventions and policy changes could significantly reduce the life expectancy gap and enhance holistic wellbeing for people living with mental illness.

Conclusion

In conclusion, the substantially reduced life expectancy among people with mental illness is a severe yet modifiable health inequity. Health systems, communities, and governments must prioritise multi-level strategies with the potential to close this gap. With sustained efforts targeting the interacting determinants through policy reform, health system enhancement, and stigma reduction, this concerning disparity can improve, which would lead to prolonged, meaningful lives for people living with mental illness.

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