Improving health outcomes for people with coexisting mental and physical conditions: an integrated approach

Preface
The objective of the 2019 National Symposium on coexisting mental and physical health conditions is to bring experts together to consider how best to address the significant physical health disparities experienced by people living with a mental health condition through improved policy, practice and health system change. Physical and mental health are fundamentally linked in the body, but disconnected in Australia’s health system. Looking after our physical health is important. For people living with mental health conditions, maintaining physical health can be more challenging, especially when confronted by a fragmented health system where inequities in access still exist. More than four million Australians live with mental health conditions such as anxiety, depression or psychosis. These four million Australians – many of whom are our friends, our family and our neighbours – are at much greater risk of chronic disease and much greater risk of dying an early death. Each year over 11,000 people living with mental illness die prematurely from the 10 main causes of early death. Early death due to suicide accounts less for less than one in 10 of these early deaths of people living with mental illness [1]. Australian data show that the gap in life expectancy for people living with severe mental illness is approximately 20 years, and more than three quarters of the excess mortality
comes from physical health conditions such as cardiovascular disease and cancer. In cardiovascular disease almost 70% of these early deaths are preventable [2]. This background paper provides a summary of the evidence of the health risks for people living with mental health conditions; and illustrates the adverse health outcomes associated with mental and physical comorbidity. Leading experts were approached to co-author specific sections of the paper focusing on action areas relevant to their expertise. These ‘action areas’ are consistently recognised as critical factors that impact mental and physical health. Expert co-authors have contributed to an overarching review of the evidence for what works to improve health outcomes across the identified action areas. They have also provided examples of how the evidence can be translated to policy and system changes that will reduce the fragmentation of services that puts individuals at risk of poorer health. The National Symposium represents a commitment by many individuals and organisations to collaborate on the development of evidence-based, feasible and implementable policy advice to bring about change that will make a difference. Participants at the National Symposium are representative of the span of health, advocacy and service provider sectors that have a role in and are committed to improving the physical health of people with mental health conditions. The event also provides an opportunity for members of the new Parliament to meet with Symposium participants and to consider the importance of preventive health services and are in addressing coexisting mental and physical conditions. Achieving effective change for millions of individuals through improved health care requires the shared and ongoing commitment and cooperation of those with knowledge, power, influence, and responsibility. Collaborative leadership is the cornerstone of change that is urgent, complex and challenging. This National Symposium builds on the work of many others and provides a platform for ongoing collaboration and leadership to bring about the changes that will allow people with mental health conditions to enjoy better physical health.