How the mentally ill can protect their health

People with mental illness face special health challenges. Yet they often get inadequate medical care. Are you, or a person you know, among them?

Here I’ll discuss the health care disparities of people in this country with mental illness. And I’ll suggest simple steps you can take to help protect your health.

CAUSES OF POOR HEALTH

If you suffer from anxiety, depression, bipolar disorder, addiction, schizophrenia or another mental disorder, your condition may make it more difficult for you to get the medical care that you need.

Mental illness may impair your ability to recognize health problems or communicate your concerns to your health care provider. You may have trouble remembering your appointments, following through on your provider’s instructions or planning your future health care needs.

One study found that half of patients with serious mental illness didn’t take their medicines regularly. They also had great difficulty keeping appointments and recognizing illness symptoms in the study.

People with mental disorders often have decreased access to health insurance and medical care. Because of the cost, they may delay seeking medical care and are less likely to receive preventive services such as vaccinations, cancer screening or counseling about unhealthy lifestyle habits. In addition, in one study, only half of people with mental illness reported visiting a health care provider regularly.

Financial barriers are frequently present. As many as 50 percent of people with serious mental illness have income below the poverty level, and about 80 percent are unemployed. Trouble finding transportation to get to medical appointments, and difficulty paying for medications or other treatments, may also make it challenging to get good medical care.

FREQUENT HEALTH PROBLEMS

As a result, people with mental illness often have additional health problems that are poorly controlled, untreated or undiagnosed. Common medical conditions in patients with mental illness include obesity, diabetes, digestive disorders, high blood pressure and chronic heart or lung disease.

TAKING CARE OF YOURSELF

It’s important to take your health seriously when you have mental illness. After all, you’re the No. 1 member of your health care team. Some important points:

Get regular medical care: Bring a list of all your prescription and over-the-counter drugs and supplements to your appointments with your health care provider. Ask your provider to screen you for health conditions as well as drug interactions and side effects.

Learn all you can by asking questions about your physical and mental health conditions each time you’re seen: Have a friend or family member come along to listen and ask questions as well.

Avoid tobacco, alcohol and illegal drugs: They can interact adversely with your medicine and lead to other problems. If you use them, ask your provider about getting help so you can stop.

Obtain adequate rest and sleep: You will feel and function better when you do. Seven to eight hours of sleep each night is recommended.

Get more physical activity: Exercise burns calories to keep you slimmer and trimmer, and helps improve mood. Gradually increase activity to 30 minutes of moderate exercise, at least five days a week, with your provider’s OK. Popular options include walking, biking, swimming, gardening or sports.

Be careful what you eat: Balance your meals with fruits and vegetables, whole grains, low-fat dairy products and lean meat. Excess weight can contribute to health conditions such as diabetes, high cholesterol, high blood pressure or heart problems. If you’re having trouble losing weight, talk to your health care provider.

For more information: American Academy of Family Physicians, familydoctor.org.

Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column consult your health care provider.

&Copy; 2008 Elizabeth S. Smoots