Background
A National Call to Action
for the Wellness of People with Mental Illnesses
The early mortality rates of people with serious mental illness – up to 25 years life lost – have recently received much-needed attention. This disparity in life expectancy is unacceptable. People with serious mental illnesses deserve to live as long and healthy lives as other Americans.
As the National Association of State Mental Health Program Directors (NASMHPD) Medical Director’s Council recently reported the “increased morbidity and mortality are largely due to treatable medical conditions that are caused by modifiable risk factors such as smoking, obesity, substance abuse, and inadequate access to medical care.”
Among the variety of causative factors resulting in this disparity are: higher rates of cardiovascular disease, diabetes, respiratory disease, infectious disease (including HIV); higher risk factors due to high rates of smoking, substance abuse, obesity, “unsafe” sexual practices; increased vulnerability due to poverty, social isolation, trauma and incarceration; a lack of coordination between mental and primary healthcare; stigma and discrimination; side effects from psychotropic medications; and an overall lack of access to healthcare – particularly preventative care. In addition to the tragedy of early death, it should also be noted that the higher rates of acuity of health conditions result in greater health costs to the nation.
There are also multiple strategies that need to be employed to effectively address this issue including:
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Improved data collection to track, measure and monitor co-morbidity and mortality and systems effort in reducing this disparity;
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Identification, evaluation, and adoption of effective policies and practices – including the financing - for prevention/health promotion, screening, and access to quality, integrated, individualized care and treatment that fosters recovery;
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Training and education of consumers, youth, families, providers, and administrators; and
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Leadership and advocacy to influence and effect needed change.
In addition to NASMHPD, a range of groups have expressed interest and have begun to address these issues including providers, advocates, consumers, researchers, families, and others. The reduction and elimination of this disparity, however, will require a coordinated and strategic approach among all stakeholders.
The public health crisis of early mortality can be solved. People with mental illnesses and their loved ones are relying on us moving from attention to action to ensure that every American has equal access to our fundamental ideals: life, liberty, and the pursuit of happiness.
Goals and Method
The major goal of this effort is to reduce early mortality by developing a coordinated and strategic action plan among multiple stakeholders.
To address this goal, the Center for Mental Health Services (CMHS), within the Substance Abuse and Mental Health Services Administration, sponsored a two-day meeting in early summer of 2007 composed of invited representatives from Federal, State, County, mental health and primary care providers, researchers, consumers, families, funding agencies, accreditation bodies, advocates, and others. A planning committee of experts in this area along with CMHS staff met by teleconference 2-3 times to identify participants, recommend a facilitator and a site, subject pre-meeting technical papers and authors, and develop a meeting agenda.
Individuals to be invited will include those who have an interest and willingness to work together. A letter will be sent to all invitees clearly stating the purpose of the meeting and what participants can expect. CMHS, through a contractor, will fund and arrange all logistics for the meeting, e.g., travel, lodging, material development, etc.
An impartial facilitator will guide the group using a prepared and distributed agenda including the use of plenary sessions to identify an overall, measurable goal for the strategic action plan as well as breakout groups to develop specific, measurable, action steps. A series of technical papers will be commissioned in the strategic areas noted above to guide the discussion
The facilitator should have an understanding of current issues related to early mortality. He or she should also: keep the discussion moving; create a safe, welcoming environment; be able to summarize; have experience in dealing with different viewpoints; be sensitive; and be detail-oriented. CMHS staff and the planning committee will meet with the facilitator to plan the agenda and to be clear about preferred outcomes.
Outcomes
A national action plan will be drafted based on the meeting’s deliberations. This will be shared with participants for their feedback prior to it being finalized and disseminated to guide a national wellness initiative.
Finally, it is also hoped that this meeting and action plan will provide an impetus for others to join in the promotion of wellness for mental health consumers.
For more information, please contact Paolo del Vecchio, Associate Director for Consumer Affairs, SAMHSA/CMHS at paolo.delvecchio@samhsa.hhs.gov or call (240) 276-1946.
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