People with mental illness still at risk of dramatically shortened life, survey claims

People with mental illness are being prescribed medication without understanding the risks and side effects, and going without vital health checks that leave them at risk of a dramatically shortened life, a survey has revealed.

The survey of more than 200 people who are on – or caring for someone on – antipsychotic medication, conducted by Rethink Mental Illness and launched to coincide with Mental Health Awareness Week, found that 62% said the risks, benefits and side effects were not adequately explained to them.

People with severe mental illness die, on average, 20 years earlier than the rest of the population, largely because physical health problems are often missed or cast aside as symptoms of mental illness; or because of complications associated with side effects of medication. Yet 51% of those surveyed said they had not received a physical health check when their medication was prescribed; and 54% said they had not discussed any ongoing physical health symptoms with their GP or health professional.

The survey also found that 46% of respondents said they did not understand the different medication options available to them. A similar number (47%) said they did not feel part of the decision making process when their medication was prescribed.

It also found that 27% said it had been more than a year since their last medication review, despite NICE recommending annual reviews for anti-psychotic medication.

More than 30 side effects of antipsychotic medication were reported by respondents, with 81% saying they experienced weight gain. Other side effects included facial twitches, insomnia and sexual problems.

Brian Dow, director of external affairs at Rethink Mental Illness, said: “Medication for severe mental illness can be a life saver. However, too often we are hearing that it’s being prescribed without a proper discussion about the side effects, risks, other options available, and perhaps even more worryingly, without taking into account the impact on physical health that medication can have.

“Imagine gaining 10 stone in weight in a year, with all the associated risks that brings, including diabetes, heart disease or a stroke, and not having this explained to you beforehand. We know that people with mental illness die on average 20 years earlier than the rest of the population, and this can largely be attributed to their physical health needs being overlooked.

“We understand health professionals face many barriers, particularly when working with people in crisis, with limited time and resources, but it’s crucial we start to see the whole person by ensuring both mental and physical health needs are addressed as one. That means more involvement, more information and an ongoing conversation about health overall.” 

Mental health and suicide prevention campaigner Jonny Benjamin added: “It’s so important that people with mental health issues are fully involved in any decision about their treatment. We need open conversations that lay out the different options available to ensure that we get the right treatment. Medication can be really helpful but it’s crucial that you are made aware what the side effects could be and how to deal with them.

“In the past I’ve found that my skin became incredibly sensitive and burnt badly in the sun when I was on one particular treatment, which I was never warned about before. Regular health check-ups can help identify and manage problems like these. When you have a mental illness your physical health can be affected in a number of ways. This is why we need to make sure that physical health is monitored and that people are supported to stay well.”

Professor Allan Young, chair of the Royal College of Psychiatrists Psychopharmacological Committee said: "These findings are of concern. People with mental ill-health need the best available integrated health care to help with their physical and mental health problems. Medication has an important part to play in both physical and mental ill-health but should be used in an informed and evidence based manner to best help patients."