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Higher rates of diabetes, heart disease and respiratory conditions in people with serious mental illnesses have been well-established by the research; the links to cancer are still emerging and preliminary findings vary depending on type of cancer. Diabetes rates are significantly elevated among people with mental illnesses. Antipsychotic medications have been shown to significantly impact weight gain; obesity rates are up to 3.

Conversely, people with diabetes have nearly twice the rate of diagnosed mental illnesses as those without diabetes. The biological impact of high blood sugar levels is also associated with the development of depression in people with diabetes. Left untreated, co-existing diabetes, poor mental health and mental illnesses can hinder self-care practices and increase blood sugar levels, contributing to worsening mental and physical health. People with serious mental illnesses often experience high blood pressure and elevated levels of stress hormones and adrenaline which increase the heart rate.

Antipsychotic medication has also been linked with the development of an abnormal heart rhythm. These physical changes interfere with cardiovascular function and significantly elevate the risk of developing heart disease among people with mental illnesses. In Canada, women with depression are 80 percent more likely to experience heart disease than women without depression. Similarly, people with mental illnesses have up to a three times greater likelihood of having a stroke. Conversely, there are significantly elevated rates of depression among people with heart disease. It is three times more likely that a person with heart disease will experience depression when compared to people who do not have heart problems.

Co-existing heart disease and mental illness contribute to worse health status and higher health care utilization rates. Figure 1.

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Source: T. People with serious mental illnesses have a significantly increased likelihood of developing a range of chronic respiratory conditions including chronic obstructive pulmonary disease COPD , chronic bronchitis and asthma. People with mental illnesses have high smoking rates, due in part to historical acceptability of smoking in psychiatric institutions, the impact of nicotine on symptom control, and the positive social aspects of smoking. Social factors such as poverty, unstable housing, unemployment and social exclusion may also impact upon both smoking rates and the development of respiratory conditions, but there has been little research on this topic among people with serious mental illnesses.

People living with chronic respiratory diseases experience significantly elevated rates of anxiety and depression.

People who experience asthma attacks similarly have a greater likelihood of experiencing anxiety and panic disorders. In addition, some asthma medications have been demonstrated to alter mood.

87 Best Book hormones and mental health images in | Thoughts, Inspirational, Positive thoughts

The research linking mental illness and cancer has yielded mixed results. Recent research has found significantly higher rates of cancer among people with schizophrenia than expected. Many studies have found decreased rates of respiratory cancers among people with serious mental illnesses; it has been suggested that this lower risk may be linked with past institutionalization which may have protected people from environmental risks.

People living with cancers face a higher risk of developing depression, due in part to high levels of stress, emotional upset, and changes in body image. For example, older women with breast cancer and a diagnosis of depression were significantly less likely to receive optimal treatment. Research has consistently found a lower rate of arthritis in people with serious mental illnesses than the general population. It has been previously suggested that schizophrenia may reduce the risk of developing arthritis due to genetics, the anti-inflammatory side effects of antipsychotic medications, and more sedentary lifestyles linked to institutionalization and illness.

However, it has been argued that rates of arthritis may in fact be underreported in people with serious mental illnesses due to a reduced likelihood of reporting pain. By comparison, people with arthritis are at significantly elevated risk of developing mood and anxiety disorders.

Mental Health Recovery and Resiliency, Module 1 of 4

People with serious mental illnesses face many barriers to accessing primary health care. These barriers are complex and range from the impact of poverty on the ability to afford transportation for medical appointments to systemic barriers related to the way that primary health care is currently provided in Ontario.

For example, people with mental illnesses who live in precarious housing may not have an OHIP card due to the lack of a permanent address or a safe place to store identification. Some physicians may also be reluctant to take on new patients with complex needs or psychiatric diagnoses, due to short appointment times or lack of support from mental health specialists. The stigma associated with mental illness also continues to be a barrier to the diagnosis and treatment of chronic physical conditions in people with mental illnesses.

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Stigma acts as a barrier in multiple ways. It can directly prevent people from accessing health care services, and negative past experiences can prevent people from seeking health care out of fear of discrimination. Furthermore, stigma can lead to a misdiagnosis of physical ailments as psychologically based. People with serious mental illnesses who have access to primary health care are less likely to receive preventive health checks. They also have decreased access to specialist care and lower rates of surgical treatments following diagnosis of a chronic physical condition.

The mental health of people with chronic physical conditions is also frequently overlooked. Diagnostic overshadowing can mask psychiatric complaints, particularly for the development of mild to moderate mental illnesses. Short appointment times are often not sufficient to discuss mental or emotional health for people with complex chronic health needs. There are several initiatives in Ontario that can help to reduce barriers to health care. The Chronic Disease Prevention and Management Framework being implemented in Ontario has the potential to address the importance of emotional and mental health care for people living with a chronic physical condition.

Collaborative mental health care initiatives such as shared care approaches are linking family physicians with mental health specialists and psychiatrists to provide support to primary health care providers serving people with mental illnesses and poor mental health. Some community mental health agencies have established primary health care programs to ensure their clients with serious mental illnesses are receiving preventive health care and assistance in managing co-existing chronic physical conditions.

However, these initiatives currently lack sufficient infrastructure, incentives and momentum. CMHA Ontario is active in supporting people to promote their mental and physical health. We do this by advocating for increased access to primary health care, as well as for more affordable housing, income and employment supports, and for healthy public policies that address the broad determinants of health.

She has authored professional journal articles on the topics of pituitary disorders, child and adult trauma, and play therapy with children, as well as articles for the popular press.

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