Singapore

Mentally ill people likely to die earlier

Studies show their life expectancy at about 20 years lower than general population as many of them also have chronic physical ailments

About half of patients with mental health disorders also end up with chronic diseases, which reduce their life expectancy by about 20 years compared with the general population.

The National Healthcare Group's (NHG) book, River Of Life, lists the life expectancy of 891 Institute of Mental Health (IMH) patients who died between 2015 and 2016 as 64.3 years. The national average is 83.1 years.

Half of these patients also had chronic physical ailments, said NHG, which looks after IMH.

Experts told The New Paper that mental health issues can have a direct impact on physical health, so psychiatric patients are at higher risk of having physical illnesses.

This has also been documented worldwide.

Dr Sharon C. Sung, assistant professor at the health services and systems research programme at Duke-NUS Medical School, said: "In the most recent Singapore Mental Health Study, researchers found that approximately 50 per cent of those with a mental health condition also had a chronic physical health condition."

The experts stressed that this is why it is important not to view and treat the two conditions in isolation.

Dr Alvin Lum, head of medical care at IMH, said the correlation can be attributed to certain medications and factors that research has found can lead to increased metabolic illnesses such as diabetes, hypertension, hyperlipidaemia and obesity in patients with mental illnesses.

He said some mental health- related factors that can cause physical problems include smoking, lack of physical activities, poorer medical care, passivity towards screening tests and unhealthy diets.

Dr Lum added: "This is linked with higher morbidity and mortality for patients with mental illnesses, leading to reduction in life expectancy."

Dr Angelique Chan Wei-Ming, associate professor at the health services and systems research programme, Duke-NUS Medical School, said: "Depressed patients often report more chronic pain.

"The connection between mind and body is bi-directional.

"Having chronic pain, disability or mobility limitations can lead to depression, social isolation and loneliness."

Dr Chan said loneliness can also predict mortality.

She said the mental resilience of an individual can also affect their body's ability to recover from physical injury.

Dr Lum told TNP that IMH also screens patients for physical ailments and referrals will be made to the medical care clinic.

Its team of family medicine doctors will follow up with and stabilise patients with metabolic conditions.

He said: "Although there are some patients who refuse treatment for their physical ailments or are not compliant with treatment, we need to reach out to them, build rapport with them and explain the importance of such management."

A 50-year-old man who was diagnosed with schizoaffective disorder said he felt hopeless when he found out that he had diabetes 10 years ago and then glaucoma three years later.

He feared he would lose his leg to diabetes and his eyesight to glaucoma.

"I sometimes hoped I would not live too long," he told TNP.

With help from mental health experts, he has since come to terms with his mental and physical ailments.

The experts noted that mental wellness and resilience often has to start at a young age.

Madam Choy Wai Yin, director of guidance, student development curriculum division, in the Ministry of Education (MOE), said the ministry has a team of specialists who are trained in the relevant fields of psychology, counselling and prevention science.

They monitor student well-being, design curriculum and programmes to support mental well-being, as well as conduct training and consultation for school personnel to implement the mental health programmes.

"The MOE specialists, together with school counsellors and teachers, work closely as a multi-disciplinary team to support our students' mental health," Madam Choy said.

"The mental well-being of our young ones cannot be left to schools alone. It must be the shared responsibility of parents, schools and the community at large.

"Each of these parties plays an important part in providing the necessary guidance and support for our children."

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MEDICAL & HEALTH