Set against a context of pressing physical conditions, people (and policy makers) can veer towards neglecting mental health in favour of focusing on their more ‘obvious’ health problems. However, as mental healthcare providers, we know and understand that it is impossible to divorce the physical from the mental, and that the two facets of our health go hand in hand.
People with diabetes, for example, are at a greater risk of suffering from depression and anxiety than the rest of the population but have historically been under-diagnosed. Anxiety symptoms can sometimes be mistaken for those of hypoglycaemia (low blood sugar) for example, leading people to over-medicate with insulin and potentially see long-term complications in how they manage their condition.
Smoking is another good example of where physical and mental health intersect. Forty per cent of people with psychosis are smokers and 66% of premature deaths among this group are attributable to treatable cardiovascular and pulmonary diseases linked to smoking, not to things like suicide or self-harm.
In both examples, where either the mental or physical health conditions go untreated, it can lead to increased care costs and a less favourable outcome for the individual. That’s why it’s so important for the NHS to provide treatment and care for the whole person and avoid operating in silos which look at either the mental health issue or the physical problem, but not both.
The push for parity of esteem – for equality between mental and physical health – is well documented. However, until the culture of prioritising funds into acute trusts who provide physical healthcare and freezing or reducing spend with mental health providers is reversed, this will be difficult to achieve.
Mental health conditions account for 22.8% of the UK’s health conditions – that’s greater than cardiovascular disease (16.2%) and cancer (15.9%) and yet they typically receive less than 12% of the NHS spend. This is a major health inequality and one which needs urgent attention and proper funding in order to be tackled.
Ultimately, the argument that there can be with health without mental health can be illustrated by a single, stark fact: Londoners with mental health problems have a shorter life expectancy than the rest of the population – they may often die over a decade earlier than their peers.
This World Health Day we ask policy makers to invest in Londoners’ mental health through well-funded and well-resourced specialist services as a priority.