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The study by Michell et al (Psychological Medicine (doi:
10.1017/S003329171100105X)) showing that many patients receiving treatment
for mental disorder did not have their physical health needs adequately
addressed undoubtedly warranted highlighting in a journal of general
readership rather than being left to languish within a more specialty
focused journal of lesser readership. However to highlight it under the
title "Psychiatrists neglect patients' physical health problems, says
study" is selective, perjorative and perpetuating of negative stereotypes.
The paper does rightly lay considerable responsibility at the door of
psychiatrists, particularly in their role in prescribing medications with
known cardiometabolic side effects. However it also emphasises the need
for better integration of primary and secondary care services, including
secondary physical health care and not just secondary mental health care.
Studies were carried out in five different countries (UK, US, Canada,
Australia & Spain), each with quite different models of healthcare
delivery.
The paper highlights with concern the high premature mortality rate
in people with mental disorders and that the existing evidence suggests
that physical comorbidity is often unrecognised and inadequately treated
in those with mental ill health. Psychiatrists do need to improve their
awareness and practices in regard of physical health but the message is
also that all doctors irrespective of speciality need to maintain an
awareness of, and have an index of suspicion for, impaired physical health
in those known to have a mental health problem.
Competing interests:
AFC is a consultant psychiatrist who prescribes psychotropic medications to patients with mental health problems
Important study but inappropriate titling
Sirs
The study by Michell et al (Psychological Medicine (doi:
10.1017/S003329171100105X)) showing that many patients receiving treatment
for mental disorder did not have their physical health needs adequately
addressed undoubtedly warranted highlighting in a journal of general
readership rather than being left to languish within a more specialty
focused journal of lesser readership. However to highlight it under the
title "Psychiatrists neglect patients' physical health problems, says
study" is selective, perjorative and perpetuating of negative stereotypes.
The paper does rightly lay considerable responsibility at the door of
psychiatrists, particularly in their role in prescribing medications with
known cardiometabolic side effects. However it also emphasises the need
for better integration of primary and secondary care services, including
secondary physical health care and not just secondary mental health care.
Studies were carried out in five different countries (UK, US, Canada,
Australia & Spain), each with quite different models of healthcare
delivery.
The paper highlights with concern the high premature mortality rate
in people with mental disorders and that the existing evidence suggests
that physical comorbidity is often unrecognised and inadequately treated
in those with mental ill health. Psychiatrists do need to improve their
awareness and practices in regard of physical health but the message is
also that all doctors irrespective of speciality need to maintain an
awareness of, and have an index of suspicion for, impaired physical health
in those known to have a mental health problem.
Competing interests: AFC is a consultant psychiatrist who prescribes psychotropic medications to patients with mental health problems