The life expectancy of a schizophrenic or a bipolar person is cut by 20 years. This inequality testifies to the shortcomings of the healthcare system.
This has been a dramatically stable figure for several decades. The life expectancy of a severely mentally ill person is cut by twenty years. A study conducted in Northern Europe and recently published in the British Journal of Psychiatry confirms the finding. Between 1987 and 2006, the life expectancy of patients hospitalized in psychiatry increased in parallel with that of the general population, but the 20-year gap between the two curves has not changed. This concerns people suffering from schizophrenia, bipolar disorders but also certain forms of depression or anxiety disorders.
The causes of this discrepancy are clearly identified. In order: suicide, accidents, largely linked to suicide attempts, cardiovascular disease and cancer. In other words, causes on which we should be able to act through prevention and screening. What the mental health care system has so far clearly been unable to do.
Prof. Christophe Lançon, psychiatrist, Sainte Marguerite hospital in Marseille: “Can psychiatry do prevention? The proof is absolutely no “
Psychiatry is often criticized for losing interest in the body of its patients in order to focus solely on the suffering of their mind. Historically, this medical specialty was not built to save the lives of its patients but rather to bring them to their senses or isolate them from the rest of society. But psychiatry is not the only one responsible for this excess mortality. It is the entire healthcare system that struggles to take care of patients suffering from mental pathologies. However, it is known that their living conditions in isolation and socio-economic precariousness, the excessive consumption of alcohol, tobacco and cannabis as well as some of their drug treatments expose these patients more to overweight, hypertension or to diabetes.
Prof. Christophe Lançon, psychiatrist, Sainte Marguerite hospital in Marseille: “The diagnosis of mental illness excludes you from the usual health care system”.
Non-psychiatrist caregivers often say they have difficulty in dealing with this type of unpredictable patient. Christophe Lançon therefore suggests that psychiatrists themselves ensure this mission of prevention in the broad sense, from the search for suicidal thoughts to advice on hygiene of life for an overweight patient. This position is far from unanimous among psychiatrists. A large majority of them also consider the creation of specific devices that would allow patients suffering from mental disorders to have access to so-called somatic care as stigmatizing. Patient associations, such as the FnaPSY (National Federation of Psychiatric Users) are convinced of the contrary and are campaigning for the creation near psychiatric hospitals of medical homes dedicated to somatic care and the management of addictions.
It remains to be seen what orientations will be retained in the Psychiatry and Mental Health 2011-2015 plan, the broad outlines of which are expected for next month.
