U.S. mental health survey of people with schizophrenia and providers

Jan 31 2008

Mental Health America has released results of the first national online survey to examine overall healthcare in mental health settings from the perspective of both people with schizophrenia and psychiatrists.

Results showed that although both groups are aware of actions to improve overall health and quality of life, they are not discussing such actions to the extent possible.

Mental Health America conducted the survey in response to recent data showing that people with serious mental illnesses – including schizophrenia – die at least 25 years earlier than the general population, largely due to preventable medical conditions such as diabetes, cardiovascular disease and respiratory and infectious diseases. Nationwide, rates of chronic illnesses such as heart disease and diabetes are at epidemic levels. Nowhere is this public health dilemma more evident than in people with serious mental illnesses such as schizophrenia, who die at nearly twice the rate of the rest of the population from heart disease and diabetes.

“We should all be alarmed and outraged that the lives of people with schizophrenia are being cut short by 25 years,” said David Shern, Ph.D., president and CEO of Mental Health America. “This survey tells us that mental health providers and people with schizophrenia must communicate more about issues like diet, exercise and medication side effects if we're to turn the tide of this public health crisis and extend the lives of the millions of Americans with schizophrenia.”

While 40 percent of survey respondents have private health insurance, they still report significantly higher rates of chronic illnesses than the general population. 44% and 23% of all respondents reported being obese and having diabetes, respectively, compared to 26% and 8% of the general population.

Key survey findings include:

While many psychiatrists report asking or discussing general health issues with their patients, 83% of psychiatrists cited lack of time during patient visits as the main obstacle to providing overall care; 74% feel they are not as well equipped to address the patient's overall health as are primary care physicians.
82% of consumer respondents feel that treatment of their overall health - not just their mental illness - is important to their recovery. Yet nearly half expect their psychiatrist to focus exclusively on their mental health (48%), rather than overall and mental health.

Medication Side Effects

The survey also points to significant concerns about medication side effects. Experts suggest that some commonly-used mental health medications, namely second generation atypical anti-psychotics, which are associated with weight gain and other side effects, may be putting people with schizophrenia at much greater risk for obesity and diabetes. The survey found that:

69% of people with schizophrenia reported that they have discontinued use of medication due to side effects that negatively impacted their quality of life. Almost 40% of consumers reported that the longest they had continuously remained on one medication was less than a year.

When choosing from a list of side effects considered when prescribing antipsychotic medication, diabetes was most often cited by prescribers, with 94% of psychiatrists considering it “extremely” or “quite” important.

“When people with schizophrenia stop their medications, their mental health is jeopardized and they are not able to take the best care of themselves,” said Joseph Parks, M.D., president of the Medical Director's Council of the National Association of State Mental Health Program Directors. “As psychiatrists, every one of us must redouble our efforts to protect the health and promote the wellbeing of our patients with schizophrenia. I think it's outrageous that over a quarter of psychiatrists don't see this as their responsibility to ensure patients receive appropriate care for all health problems.”

About Schizophrenia

Schizophrenia is a chronic form of psychosis that affects approximately 2.4 million adults[i] and at least 1.25 million families[ii] in the United States. The disease is characterized by positive and negative symptoms such as hallucinations, delusions, poverty of speech, disorganized thought and emotional blunting.[iii] Severity of symptoms and the chronic pattern of schizophrenia often cause a high degree of disability for patients, impacting families, caregivers and communities.[iv] In 2002, schizophrenia cost the United States $62.7 billion.[v]

About the Survey

"Communicating About Health: A Mental Health America Survey of People with Schizophrenia and Providers” was conducted by International Communications Research, a leading independent research company. Surveys were conducted online between September 17 and October 12, 2007 among a sample of 250 adults with schizophrenia (ages 18 and older) who had been diagnosed by a qualified medical professional as a person with schizophrenia and 250 psychiatrists.

The group of consumers was provided by an online research panel that maintains a nationwide sample of respondents and rigorously checks the quality and validity of the sample. Average age of consumer respondents was 38, with a majority being female (56%), Caucasian (76%), employed – paid or unpaid – (52%) and from various incomes and geographic regions.

Physician respondents were comprised of practicing psychiatrists who treat people with schizophrenia and are members of a national, verified online research panel. Average years in practice for physician respondents was 12, with a majority being male (69%) and seeing 11 or more schizophrenia patients each month (81%). Respondents were from various geographic regions and worked in public, private and integrated health settings. The margin of error for the survey is ± 6.2%.

The survey was funded by an unrestricted educational grant from Solvay Pharmaceuticals and Wyeth Pharmaceuticals and by an anonymous individual donation.