Mental Health and Mortality: Putting it all in Perspective

Published: June 5, 2014

The misperceptions about those with “mental health problems” are numerous. They range from overgeneralizations about the perceived dangerousness of those with a psychiatric illness to stereotypes about people who are “too lazy” to simply take action and pull themselves up by their bootstraps. Journalists are quick to highlight the “mental state” of gunmen who chose to take the lives of the innocent, as was recently reported in the mass shooting in Los Angeles. Even in benign examples there exists the misconception that only those with “real problems” need to seek formal mental health treatment, and that if/when someone chooses to do so, it should be spoken about in hushed tones behind closed doors. Unfortunately, this has created a culture wherein we have made taboo discussions of mental health topics that are highly prevalent. Even worse, we have thus created a barrier to treatment, as many feel that seeking these sometimes life-saving interventions would be too greatly stigmatizing. Meanwhile, most would seek medical treatment for conditions like diabetes, heart failure, and/or arthritis with little to no hesitation.

Though not its direct aim, a recent study conducted by researchers from Oxford University helps put into context the relative severity of mental illness and the importance of seeking appropriate treatment. Led by psychiatrist Dr. Seena Fazel, the researchers conducted a meta-review of over 1.7 million patients across 20 separate reviews and found that all disorders elevated risk for all-cause mortality compared with the general population, with substance abuse and anorexia nervosa demonstrating the highest standardized mortality ratios. The rates of suicide among those with mental health diagnoses in this study were also high. Individuals with borderline personality disorder and affective disorders (e.g., depression, bipolar disorder) demonstrated the highest completed suicide rates. But perhaps what was most staggering about the reported findings was that, separate from suicide, the mortality risk in mental health diagnoses was often much greater than that of heavy smoking – an established factor associated with increased mortality risk. Thus, in the same way that heavy smoking has been demonstrated to shorten your life expectancy, diagnoses like anorexia nervosa, schizophrenia, and bipolar disorder can also increase the risk for a shorter life expectancy. And yet, the same efforts that have been directed toward anti-smoking campaigns and public policy on tobacco have not been geared toward mental health issues. When taken together, mental illness is as prevalent as smoking in both the United States and the United Kingdom (approximately 20%), however treatment and prevention of psychiatric illness does not seem to be as great a priority. The treatment needs of those with these sometimes debilitating disorders often go unmet, and the public education about their etiology, treatment, and prevention is sorely lacking. Study authors point out that these often unmet needs contribute to the social burden and costs of mental illness which, paradoxically, can create even further stigma.

Thus this recent study helps to highlight the gaps in our current treatment and understanding of mental illness. It reminds us that stigmatizing these all too common conditions only serves to perpetuate the illness, as many will be unwilling to obtain the treatment they so desperately need. It is then incumbent upon all of us to help actively battle the stigma. We can achieve this via large-scale efforts to improve public policy and/or lobbying state and local representatives. We can join organizations like the National Alliance on Mental Illness and organize local events for National Eating Disorders Awareness Week. Even more subtly (and perhaps more importantly), we can have informed and judgment-free conversations about eating disorders, depression, schizophrenia and other mental illnesses. We can encourage those we love to seek the treatment they need and stand with them in their recovery. Changes in how we perceive mental illness as a nation will surely not happen overnight, but it can start with you.

photo credit: Loco Steve via Creative Commons