Men­tal health needs to catch up

Kapi-Mana News - - NEWS - By JIM CHIPP

Men­tal health pro­fes­sion­als should take a les­son from other med­i­cal dis­ci­plines, ac­cord­ing to a vis­it­ing ex­pert.

Vaughan Carr is pro­fes­sor in the School of Psy­chi­a­try at the Univer­sity of New South Wales and heads the Schizophre­nia Re­search In­sti­tute.

He said clin­i­cal prac­tice and re­search go hand in hand in ad­vanc­ing the treat­ment of phys­i­cal ill­ness, re­sult­ing in steady im­prove­ments in treat­ments and re­sults.

He cites breast can­cer treat­ment as a ex­am­ple men­tal health prac­tice could fol­low.

Ill­ness is be­ing de­tected and treated ear­lier and clin­i­cal tri­als com­pare the cur­rent gold stan­dard of treat­ment with al­ter­na­tive treat­ments, he said.

‘‘ We have seen in­cre­men­tal im­prove­ment in breast can­cer mor­bid­ity and mor­tal­ity,’’ he said.

‘‘I think im­prove­ment in the qual­ity of men­tal health ser­vices would be given an enor­mous boost if there were in­fra­struc­ture es­tab­lished for the ef­fec­tive­ness of good clin­i­cal re­search.

‘‘ We need to in­te­grate our re­search ef­fort with the clin­i­cal ser­vices so that the two sup­port each other, so the re­search ef­fort im­proves the clin­i­cal work.

‘‘They should be in the same place, and cer­tainly talk­ing and work­ing col­lab­o­ra­tively to­gether.

Mr Carr said the Schizophre­nia Re­search In­sti­tute has car­ried out a large scale epi­demi­o­log­i­cal sur­vey of psy­chosis in Australia and found some dis­ap­point­ing re­sults. Although pa­tients are more satis- fied with their treat­ment over­all out­comes re­main about the same as they were 12 years ago.

Rates of drug and al­co­hol abuse among pa­tients have risen and they are less phys­i­cally healthy.

Fifty per cent are obese, 50 per cent ex­hibit meta­bolic symp­toms, such as large waist, high blood pres­sure, high serum lipids or high blood glu­cose and 25 per cent are at risk of a se­ri­ous car­dio­vas­cu­lar event in the next five years.

The sur­vey found in­creas­ing num­bers of peo­ple with psy­choses were ac­cess­ing ser­vices.

‘‘What we don’t know is the ex­tent to which those in­ter­ven­tions are soundly-based,’’ Mr Carr said.

‘‘We know, for in­stance, that cog­ni­tive be­havioural ther­apy is very ef­fec­tive but we don’t know the ex­tent to which the so-called coun­selling work be­ing pro­vided is de­liv­er­ing those treat­ments we know are ef­fec­tive.

‘‘ That’s the chal­lenge – that what is be­ing de­liv­ered has good [ev­i­dence-based] sup­port.

‘‘To be frank, I would ex­pect that there are low lev­els.’’

Gov­er­nance struc­tures should in­sist that ser­vices de­liv­ered have built- in mea­sure­ment of out­comes, he said.

Schizophre­nia typ­i­cally ap­pears in ado­les­cence or young adult­hood, so par­ents should pay at­ten­tion if their teenager be­comes more so­cially with­drawn, de­pressed, un­pre­dictable or im­pul­sive.

‘‘These are all non-spe­cific,’’ he said.

‘‘We can’t ac­cu­rately pre­dict on the ba­sis of any­thing who is go­ing to de­velop schizophre­nia.’’

Three- quar­ters of men­tal dis­eases have their on­set be­fore age 25.

‘‘You have a sig­nal that a young per­son emits that they are in some kind of trou­ble and de­serves to be taken se­ri­ously, and de­serves to be eval­u­ated, and to re­ceive treat­ment based on the eval­u­a­tion.’’

Mr Carr vis­ited Welling­ton as this year’s Chad Buckle Fel­low.

He gave a public lec­ture and also con­ducted lec­tures and work­shops for men­tal health pro­fes­sion­als.

The fel­low­ship was es­tab­lished af­ter Chad Buckle killed him­self in 2003 while a com­pul­sory pa­tient of the acute men­tal health unit in Welling­ton and each year brings an in­ter­na­tional ex­pert in men­tal ill­ness to Welling­ton.

Newspapers in English

Newspapers from New Zealand

© PressReader. All rights reserved.