Workforce development for better management of physical comorbidities among people with serious mental illness

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Collaborative and holistic care that addresses multimorbidity could reduce excess disease burden and improve life expectancy

The health burden in people with serious mental illness is considerably greater than that for the general population, with average life expectancy as much as 20 years lower for people with serious mental illness.1 Co-existing chronic physical illnesses (predominantly cardiometabolic diseases), rather than mental health issues, contribute the majority of excess disease burden leading to this life expectancy gap.1 Factors that adversely affect quality of care and health outcomes for established physical health conditions include: poor coordination of care; “diagnostic overshadowing” leading to physical health issues being overlooked; failure to refer patients to lifestyle modification programs; and lack of support for medication management.2

The Being Equally Well initiative established a roadmap to provide effective and improved care for patients with serious mental illness and co-existing physical health problems.2 For the purposes of Being Equally Well, serious mental illness was defined as including “conditions requiring antipsychotic therapy, those requiring shared care provided between psychiatrists and GPs and thought disorder conditions rather than neuroses”.3 The roadmap documented significant potential roles for nurse navigators, pharmacists and allied health professionals to support a model of care shared between general practice and mental health services in Australia.2 In this article, we describe the rationale for greater involvement by these health professional groups, to support improved physical health for people with serious mental illness in Australia.