People with severe mental illness denied essential physical healthcare services

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People with severe mental ilness in Ireland are being denied access to essential physical healthcare services, a new report has found.

The report was published today by the Mental Health Commission, which said this is both discriminatory and a breach of human rights.

Authored by the Inspector of Mental Health Services, Dr Susan Finnerty, the report – titled ‘Physical Health of People with Severe Mental Illness’ – focuses on the physical healthcare and access to essential healthcare for people in long-term care in mental health in-patient units.

The report found that some patients with severe mental illness were being discriminated against as they were being denied access to essential physical healthcare services such as physiotherapy, dietetics, speech and language therapy, and seating assessments.

“This is utterly unacceptable and a breach of human rights,” said Dr Finnerty. “I found a significant number of residents who had been assessed as needing these services but had no access to them.”

Dr Finnerty stated that people with severe mental illness deserve the same rights as everyone else, and to live healthier and longer lives.

She  added healthcare professionals have a vital role to play in helping to achieve this, and need to set the standard in raising aspirations for severe mentally ill people and in challenging discrimination.

The report also found that physical health monitoring for people with severe mental illness fell below international best practice standards.

Of those surveyed, just nine per cent had their waist circumference measured; only 25 per cent had a Body Mass Index (BMI) rate recorded; monitoring of blood lipids and electrocardiograms (ECGs) was only carried out in two thirds of residents; and while some physical health needs were outlined in some of the residents’ individual care plans, these did not include annual monitoring.

“These findings are of serious concern and show that residents in long-term care in mental health in-patient units are not adequately monitored for serious physical illness which they have a higher risk of developing than the general population,” Dr Finnerty stated.

As part of her report, the Inspector explained that people with a severe mental illness may die between 15 and 20 years earlier than the rest of the population, while research in the United Kingdom has estimated that 40,000 deaths could be avoided each year if individuals with serious mental illness were afforded the same amount of physical healthcare as the general population. The equivalent number of deaths annually based on Ireland’s population would be almost 3,000.

Dr Finnerty added that the findings of her report were particularly concerning as many of those who live or reside in continuing care mental health units are vulnerable, elderly, have poor communication abilities and are at high risk of cardiac disease and metabolic syndrome (a cluster of the most dangerous heart attack risk factors).

The Chief Executive of the Mental Health Commission, Mr John Farrelly, said that the findings of the Inspector raise safety and quality issues in relation to the physical healthcare provided to people suffering from severe mental illness.

“This report demonstrates a blatant disregard for the welfare of some of the most vulnerable members of our society,” he said. “If we are talking seriously about creating a culture of respect for human rights in this country, then we must start by working to improve the quality and standards of our mental health services, and ensuring that we eliminate all instances of discrimination.

“We must commit to move now to implement procedures that will address the concerns in this report and radically improve the physical healthcare and monitoring of mentally ill people in Ireland to ensure that they do not continue to suffer unnecessarily.”