Former social worker Ann Tullgren, of Hobart, expects her life to be cut short.
Ann Tullgren expects to die early.
The average Australian woman dies at 84. But the 61-year-old figures she’s a good chance instead to be one of the 9000 Australians a year with mental illness whose lives are cut short, on average 30 per cent, by avoidable physical illness.
That’s three times the number who die from suicide. And Ms Tullgren is “bloody angry” about it. She says the lack of adequate healthcare and rising health costs sometimes makes her think there is “a kind of creeping euthanasia” against people with mental illness.
RANZCP president Professor Mal Hopwwod. Photo: RANZCP
“Quiet acceptance” of the risk of early death for mentally ill people is an “ugly truth” about Australia, says Mal Hopwood, president of the Royal Royal Australian and New Zealand College of Psychiatrists.
Ms Tullgren, 61, a retired social worker in Hobart, has lived with bipolar disorder since her 20s. The worse thing, she says, is knowing it’s not just her but 475,000 fellow Australians with serious mental illness who “live with this problem and receive shitty care”.
Early deaths from avoidable physical sickness among people with serious mental illness cost $15 billion or 0.9 per cent of GDP a year in lost contributions to the economy, says a new report from the RANZCP. The overall cost to the economy of serious mental illness – schizophrenia, bipolar disorder, psychosis and severe depression and anxiety – is $57.6 billion a year or 6 per cent of GDP.
People with severe mental illness are at much higher risk of cardiovascular disease and diabetes especially, and get asthma, arthritis, respiratory conditions, hepatitis, epilepsy, cancers, and gastrointestinal conditions at rates “vastly in excess” of the general population, says Professor Hopwood.
Yet they use health services much less. “Unhelpful and discriminatory attitudes” and “a culture of hopelessness and low expectations” in the health system “directly contributes to the shorter life expectancy”, an earlier RANZCP report says.
About the year 2000, Ms Tullgen was prescribed the anti-psychotic medication Zyprexa, which is known to cause abnormally high blood-sugar levels and weight gain, among other side effects. Within six months she was diagnosed with diabetes. With asthma too, she needs to take about eight medications daily.
She says there is a lack of communication and co-ordination between health professionals caring for people with mental illness. Her psychiatrist is “a lovely guy, but I don’t think he has written to my GP or my GP to him for many many years”.
With professional experience in the health system, she is well able to relay information between them, but that is not possible for many people with serious mental illness. “Part of the thing about having serious mental illness is you get quite disorganised, even about taking your medication.”
Professor Hopwood says it is important for doctors to “listen very carefully” to patients with major mental problems, “knowing they are more likely than most to have a major physical health problem as well”. There should be consideration of specific Medicare items allowing longer consultations for full health assessments of people with major mental illness, he says.
The report says best practice in healthcare could reduce the impact of serious mental illness and concurrent physical illness by a third.
A funding boost to prevent early deaths, including from suicide, “could see both short-term and long-term results”, Professor Hopwood says. “As doctors we are most interested in people not numbers, but the evidence demonstrates that there is a financial windfall waiting for the government brave enough to make saving people’s lives a priority.”
Ms Tullgren doesn’t want to die young, “because I love my life, I love my husband, I have lots of friends and three cats”.
“But it is kind of just the reality”.
The report was produced by the Victoria Institute of Strategic Economic Studies and jointly funded with the Australian Health Policy Collaboration.