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Heart attack treatment less likely for people with mental health problems


People with mental health problems are less likely to be offered revascularisation, angioplasty or a bypass after a heart attack and have a higher chance of dying, research has revealed.

Some 22 studies were reviewed, showing that the chances of being offered a procedure such as revascularisation, angioplasty or a bypass after a heart attack or an episode of unstable angina was 14% lower among people with mental illness.

For patients with schizophrenia, they were 47% less likely to receive treatments.

Researchers also found that people with mental illness who experienced acute coronary events such as a heart attack had an 11% higher chance of dying than those who do not have mental health problems.

The research, which was conducted at the University of Leicester and Curtin Health Innovation Research Institute in Australia, has been published in the British Journal of Psychiatry.

The report said: “One possible explanation is the physicians do not offer procedures to those with mental illness because these individuals have poorer uptake of care.

“Another possibility is that the needs of those with mental illness are crowded out by the focus on mental concerns or other medical factors which may lead physicians to think that procedures are not a priority in this group.

“There is also a question whether people with severe mental illness follow through with advice they are given.”

The studies involved research on more than 825,000 people with and without serious mental disorders.

Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: “This research reinforces the impact poor mental health can have on the risk of dying from heart disease.

It highlights the need for healthcare professionals to provide a holistic approach to care and to recognise that the state of someone’s mental health can impact on their decision-making about potential treatments.”



Readers' comments (10)

  • Hope their care will improve.

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  • categorisation of patients and discrimination! i thought this was forbidden in medicine and nursing.

    a patient is a patient like any other and cannot be outcast and physical health put in jeopardy just because of a mental disorder!

    this attitude is appalling and must be stopped.

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  • Anonymous | 2-Jun-2011 10:49 am

    i agree.

    What about patients who have memory problems, they forget to attend will their care suffer?

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  • Talisa

    "No health without mental health"? I never imagined it was meant to be taken so literally.
    This is appalling.

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  • Anonymous | 6-Jun-2011 9:16 am

    forgetfulness never seems to be taken seriously as a valid excuse even with advancing age.
    I suppose this is because it is also open to abuse!

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  • "and to recognise that the state of someone’s mental health can impact on their decision-making about potential treatments.”

    but if they're not currently detainable under the mental health act and can retain the information, understand the consequences and communicate their decision, even if not in their best interest, then under the mental capacity act their decision must be respected.

    on the other hand... too many times i've accompanied a dementia sufferer for imaging, told the department when booking to be aware of the patient's condition, arrived and re-itereted the situation to the receptionist, only to have the patient wander out the door ninety minutes later not having been near a scanner. i realise emergencies take priority, but i still think some dementia awareness training for non-mental health staff would move things along a bit.

    unfortunately we kissed goodbye to the training budget when we voted in the condems.

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  • i am not sure that it is a good idea to inform a receptionist of a patient's condition (breech of confidentiality) and shouldn't nurses remain with confused patients for the duration of the wait and the investigation - arguments of staff shortages apart?

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  • in order for the patient to be seen in a timely manner the patients condition should be made aware to those that may be able to expedite that care. and yes, a nurse, or indeed two, may sit with a patient whilst they get bored waiting, and try to keep them occupied, distracted, etc, but if, after ninety minutes of waiting, the patient gets up and walks, then the nurses either walk with the patient, and try to maintain safety crossing the road, etc, or get into a restraint situation, which with a dementia patient who is probably "informal" rather than detained, ain't gonna happen. the only option in that situation? rebook the appointment, at the same time as trying to raise staff awareness at the imaging department, ie, my patient is not being stroppy and impatient, but has a mental health condition, which necessitates them being seen quickly, etc. etc. again and again, blah, blah, blah!

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  • Anonymous | 7-Jun-2011 6:09 pm

    difficult situation but I just think patients who are very disorientated might be better off with staff members who are more familiar to them - ideally, and, ideally, it would be preferable if they did not have any waiting time at all! a similar situation to patients going to theatres with their nurse escort from the ward who remains with them until they are anaesthetised, and they are usually seen by the theatre staff fairly promptly.

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  • @ Anonymous | 7-Jun-2011 6:24 pm

    it's good to know that at least in your neck of the woods staff realise that the elderly mentally infirm require prompt, appropriate and respectful treatment.

    such service would avoid rmn's and hcsw's having to accompany someone halfway across town until they walk off the frustation of waiting, waiting, waiting in an unfamiliar setting for a reason they do not understand. it would also avoid the poor arthritic husband or wife (someone familiar to the patient? yes, we thought of that, too!) hobbling along trying to keep up.

    i have met some pretty respectful and on the ball oda's over the years, and i'm sure not all keepers of the gateway to the imaging technology are rude and inefficient. i'm sure it's all just a training issue. but with training budgets slashed i'm doubtful of short term improvements.

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