The links between mental and physical care must be acknowledged and understood to treat the whole patient.
Understanding the integral link between physical and mental health is the first step towards providing positive, holistic care to those in our community.
The World Health Organization defines health as a state of complete physical, mental and social wellbeing, not just an absence of disease or infirmary.
Unfortunately, there can be a lack of recognition within the wider health community, and the community in general, about the relationship between physical and mental health. This can often mean the link between mind and body is ignored, resulting in negative health outcomes.
The healthcare community must recognise that mental health is a critical element of whole health, and physical and mental health should not be looked at as separate domains.
Research conducted in Australia has shown that many mental health nurses do not feel they have the authority to intervene in physical ill health. The findings also reported that whilst nurses working in mental health viewed mental and physical health to be integral to one another, they did not see physical health needs as a priority in their day-to-day care.
There has been great research into the benefits of physical healthcare in mental health sufferers. Unfortunately, without recognition of the importance of this link, people suffering from mental health issues may be missing out on positive, holistic care that could greatly benefit their quality of life. Nurses are well equipped to provide front-of-line, holistic care to patients, but without recognition that physical care is also a priority in the day-to-day care of people suffering from mental illness, their patients’ treatment may not be as effective.
The lack of recognition of the link between physical and mental health results in negative health outcomes around the world. The life expectancy of people suffering from mental illness is 20 per cent less than the general population in high-income countries. The University of Queensland conducted a study that found that mental illness sufferers in Australia are dying up to 16 years earlier than the general population, mostly due to disease rather than accidents or suicide. The research also found that people suffering from mental illness may sometimes miss the early signs of physical illness or have worse access to specialised treatment.
This reinforces the idea that the healthcare community must recognise the importance of holistic care. Whilst people suffering from an illness may be receiving specialised treatment, their physical or mental health must be monitored as well. It is important that the healthcare community prioritises treating people as people, not as conditions.
The healthcare community also has a great responsibility to recognise the risks of mental health issues in people suffering from physical illness.
Patients suffering from a chronic condition and patients who have had a sudden health event such as a heart attack or cancer diagnosis have a risk of developing a mental illness like depression. Without their healthcare team looking out for their whole health, their treatment may have negative results.
Additionally, when providing support for patients who are suffering from any physical illness, the focus can sometimes waver from providing holistic care, as the healthcare team is determined to successfully treat the patient physically. As first point of call for most patients, nurses have a responsibility to be aware that physical illness and treatment can negatively affect mental health.
Another study from the University of Queensland found that patients are much more likely to turn to their nurses, rather than other healthcare professionals, for emotional support. The study found that many terminally ill patients will act bravely towards the doctor but ask their nurse to tell the doctor they’ve had enough of their treatment.
Nurses and the wider healthcare community have a responsibility to acknowledge the wellness of a person as a whole. All nurses are provided with a fundamental knowledge of mental health as part of their initial education and an understanding that both mental and physical wellbeing are priorities when caring for any patients. Furthermore, those working in specialist mental health services need to ensure they incorporate their patients’ physical health when developing care plans for successful treatment, just as those in other settings need to consider the mental health of a person.
Increasing the focus on the link between mental and physical health, as well as support from the healthcare community and government organisations in implementing care plans and physical programs, will move us further towards providing everyone with a positive, holistic healthcare system.
Adjunct professor Debra Thoms is chief executive of the Australian College of Nursing.
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