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People with mental illness losing out on health checks

Two-thirds haven’t had drugs’ risks and side-effects explained, half haven’t had health check

Louise Prime

Wednesday, 18 May 2016

About two-thirds of people taking antipsychotic medication haven’t had an adequate explanation of their medicines’ risks, benefits and side-effects, and more than half have been unable to discuss their physical health problems with their GP or another health professional, according to the results of a new survey from Rethink Mental Illness. The charity warned that this is leaving people at risk of a dramatically shortened life, and it called on doctors to try to ensure that they address patients’ mental and physical health needs as one – despite the pressures on their limited time and resources.

To coincide with Mental Health Awareness Week, Rethink has released the results of a survey that it conducted last month (21st April to 4th May) among people either taking antipsychotic medicines to treat schizophrenia or bipolar disorder, or caring for someone else who takes them.

Earlier research has shown that people with severe mental illness die an average of 20 years earlier than people without mental illness – largely because their physical health problems are often missed, or dismissed as symptoms of mental illness; or because of complications associated with side-effects of their medication. Despite this, Rethink found that almost two-thirds (62%) of the 244 respondents said the risks, benefits and side-effects of the drugs they were taking had not been adequately explained. Furthermore, many of those surveyed were missing out on vital health checks. More than half said that they had not received a physical health check when their medication was prescribed (51%), or that they had not discussed with their GP or health professional any ongoing health symptoms (54%).

Rethink also reported that nearly half (46%) of respondents said they did not understand the different medication options available to them; over a quarter (27%) said it had been over a year since their last medication review, despite NICE recommending annual reviews for antipsychotic medication; nearly half (47%) said they had not felt part of the decision-making process when their medication was prescribed; and 81% said they experienced weight gain. The survey also highlighted more than 30 other side-effects including facial twitches, insomnia and sexual problems.

The charity’s director of external affairs Brian Dow said medication for severe mental illness was too commonly being prescribed without a proper discussion of its side effects and risks or other options available, and without taking into account its impact on physical health.

He said: “Imagine gaining ten stone in weight in a year, with all the associated risks that brings, including diabetes, heart disease or a stroke, and not having this explained to you beforehand. We know that people with mental illness die on average 20 years earlier than the rest of the population, and this can largely be attributed to their physical health needs being overlooked.”

He went on: “We understand health professionals face many barriers, particularly when working with people in crisis, with limited time and resources, but it’s crucial we start to see the whole person by ensuring both mental and physical health needs are addressed as one. That means more involvement, more information and an ongoing conversation about health overall.”

Paul Lelliott, the CQC’s deputy chief inspector of hospitals (lead for mental health), pointed out that the Mental Health Act’s ‘code of practice’ explicitly requires providers to assess and address people’s physical healthcare needs, including promoting healthy living and taking steps to reduce potential side-effects of psychiatric treatment.

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