01 October 2004

Physical and mental health closely linked

Today is the start of Mental Health Awareness Month. This year we focus on the relationship between physical and mental health. See how the one impacts on the other.

October is Mental Health Awareness Month. This year's theme is "The relationship between physical and mental health: Co-occurring disorders".

Mental wellbeing cannot be separated from physical wellbeing. The World Health Organisation describes health as "a state of complete physical, mental and social wellbeing and not merely the absence of a disease".

The five areas of health or wellness therefore comprise of:

  • Physical health
  • Emotional health
  • Social health
  • Spiritual health
  • Intellectual health

It is well known that medical illnesses often carry their own burden of mental illness. It is estimated that depression develops in 40%-60% of heart attack patients, 25% in cancer patients, 5%-10% of medical out-patients and 10%-14% of hospitalised patients.

People frequently seek help for physical ailments such as aches, pains and gastro-intestinal symptoms that may actually be symptoms of depression. This important link is often overlooked. Research has shown that depression is a brain disease affecting the structure of the brain. It is thus the same chemistry that affects both the brain and physical illnesses such as cardiovascular disease, diabetes and others.

The other side of the coin is also true. Persons with mental illness have a high risk of developing physical illnesses and some of the factors that increase this risk are alcohol, smoking, drug use, poor diet due to poverty or illness. This also applies to developing infections such as TB and HIV/AIDS. Other factors may result directly from treatment itself and can cause effects on the nervous system and metabolic function.

People with severe mental illness
For many mental health care users the accessibility of medical care may be problematic. This may be due to a lack of services, health insurance coverage or financial resources. Another problem may be as a result of not taking prescribed psychiatric medication.

On the other hand, not all medical clinicians are trained and equipped to treat the psychiatric and psychological symptoms of their patients effectively. The fact that these symptoms present in a "silent" manner other than the physical illnesses, means that they often go undetected in a large proportion of medical patients. The need for longer-term treatment with anti-depressants and/or therapy often takes less of a priority than the physical treatment.

Suggested interventions
The following interventions have been suggested to help prioritise mental health aspects of persons with health problems:

  • More integrated approaches to health care are required. Fragmented approaches should be avoided to prevent illnesses not being detected or treated.
  • Research has shown that promotional events and public campaigns do not necessarily change risk behaviour but that these should be continued as an approach, particularly through targeted programmes and outreach services.
  • Training for service providers where clinicians are trained to follow practical guidelines. This will promote early detection of both physical and mental health problems and will ensure a comprehensive assessment of physical and mental health including history on substance and sexual abuse.
  • Vulnerable communities should be identified together with stakeholders responsible for these communities. The main aim would be to bring together concerned clinicians, individuals and systems of care that can foster communication and collaboration.
  • Health care systems are often fragmented and uncoordinated which result in patients and clinicians being unaware of the resources available. Providers of mental health services should arrange programmes for their staff to support a holistic approach be taken with all patients seen at the service.
  • Offering a programme that includes talks and discussions by mental health practitioners around lifestyle issues can support mental healthcare users and their families.
  • Substance abuse and addiction are major problems for persons with mental illness. Services to deal with addiction need to be incorporated with the every day care of patients. A programme in substance abuse may lead to a significant reduction of the problem in this group.

Upcoming event
The Mental Health Programme, Department of Health, will be hosting a provincial sports day for mental healthcare users in collaboration with the Department of Sports, Culture and Recreation and other Mental Heath stakeholders such as the Associated Psychiatric Hospitals, the Mental Health Information Centre, Kingdom Ministries and Red Cross (TLC). The aim of the day is to make the public aware of the important role a healthy body plays in relation to a healthy mind and to destigmatise the negative concept of mental illness.

This event will be held on 8 October at the PENTEC sports field from 9 a.m. to 2.30 p.m. This event is open to the public. Mental healthcare users from all sectors (including intellectual disability) will be attending the day. The programme includes soccer, netball and volleyball games, physical exercises and a special programme for children with disabilities. The programme will start with a big walk for all. For more information contact Naseera Saliem on (021) 483 4003.


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