Heart, Mind, and the Healthcare Gap

Posted on June 10, 2011

Alan Miller
Clerical Unit, Fountain House

New research from the University of Leicester in the UK raises concerns about higher than expected mortality rates following acute coronary events, such as heart attack, in those with serious mental health issues. The same researchers, Leicester and Curtin Health Innovation Research Institute in Australia, examined 22 previous studies involving 825,754 individuals, comparing care given to those with and without serious mental disorders.
Researchers discovered a higher than expected mortality following acute coronary events, such as heart attack, in those with significant mental ill health. Furthermore those diagnosed with severe mental health issues were 14% less likely to receive essential coronary care procedures following their heart attack, including coronary artery bypass graft and coronary angioplasty – both of which have improved outcomes in the general population.
In 10 studies that specifically addressed care for people with schizophrenia, those with the disease received only half the interventions offered to those without schizophrenia.
Six other related studies involving 813,241 individuals examined mortality following cardiac events. They demonstrated an 11% higher mortality rate in the year after acute heart disease for those with psychiatric diagnoses as compared to those without.
People with known mental health conditions have a higher background rate of cardiovascular risk factors such as smoking, inactivity, and obesity, reflected in a higher rate of heart disease. But this analysis shows that mortality is greater even after patients receive medical care. The doctors and researchers don’t know the reason for these poorer outcomes yet, but they are concerned.
It seems to me that patients with significant mental health problems should be considered a vulnerable group; they should be receiving at least equal and, possibly, better care. We urgently need to know whether patients are declining treatment or whether clinicians are not offering treatment to an equal degree!

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