There is no question people with a severe mental health diagnosis die on average of 15-20 years younger than the general populations. Studies continue to evidence further data suggesting the mortality gap is due to higher co-morbities with psychical diseases on account of unhealthy lifestyle choices. According to a new study utilizing a randomized control trial, this hypothesis was put to the test. The study by Sampogna G, Fiorillo A, Luciano M,Del Vecchio V, Steardo L Jr, Pocai B,Barone M, Amore M, Pacitti F,Dell’Osso L, Di Lorenzo G, Maj M and LIFESTYLE Working Group (2018) A randomized Controlled Trial on the Efficacy of a Psychosocial BehavioralIntervention to Improve the Lifestyle ofPatients With Severe MentalDisorders: Study Protocol aimed at evaluating the efficacy of psychosocial behavioral interventions targeting improving the lifestyle, and in turn, health of patients with severe mental disorders, using the BMI (Body Mass Index) as a anthropometric parameter to evaluate the study’s outcomes.
The efficacy and effectiveness of the interventions implemented in the study carried with them a largely evidenced belief in medicine and health sciences that when patients experience a reduced BMI reading, in turn, their health will improve. Thus, the life span of patients will increase of people with severe mental health disorders who carry with them unhealthy practices due to their organic brain disease and dysfunction. But the study leaves out a few key pieces of information, relying on stereotypical beliefs on people with a severe mental health disorder, and takes a very medical model approach to the application of so-called psychosocial interventions. I am suggesting that this article casually assumes that people with a mental health disorder have unhealthily practices, dietary, and sedentary lifestyles without the adequate amount of excessive.
Where is the data tracking the exercise routines of the mentally ill? I am going to go ahead and tell you. The study utilizes data from the hospital systems in several counties. Given that all countries have the same basic set-up for out-patient treatment centers, the location and whereabouts of the six locations of this study were irrelevant. I have journeyed to treatment centers, both in-patient, and out-patient, in the United States, Caribbean, Europe, and Far East Asia, the same stricture, design-element, and practices are implemented with little variation except for the arrangement of the acronym the clinician uses to pronounce the intervention and its spelling.
This is why I am not impressed by the transnational data pool evaluating the exercise routines, and physical exertion of those with a mental illness, in the United States, or abroad. We need to remember people in the hospital, or being treated in an out-patient network, are being prescribed in very high doses trials of first, second, and atypical psychotics which are highly sedating medications promoting the very lethargy and in-activity associated with having a severe mental illness. Indeed, where is the data pool from people not taking medication and managing their illness without debilitating anti-psychotic medication—-and other intrusive medical interventions?
This study seems like another medical intervention being hailed as the new gold standard of psychiatry and psychotherapy. But, with enough inspection, a very different narrative is playing out in the world of mental health treatment. We cannot misread studies like this, and others which without hesitation compulsory justify even further intrusive interventions and push the agenda of medicine and psychiatry on people with a mental health diagnosis without real facts instead of promoting science on the assumption of stereotypes and other unfair and misrepresentations of people with a mental health disorder.
Indisputably then, the BMI would be a great index to use when framing the hazards of real side effects, weight gain, nerve damage, and retardation of reflexes etc. The goals however of this study’s intervention were clear and seemingly innocuous: 1) an improvement in dietary habits, 2) decreased or reduced smoking, 3) the discontinuation or reduction of sedentary behavior and other unhealthy lifestyle choices. Thus, if this studies goals are reached, people within a severe mental health disorder would be more likely to live longer?
There is no question that everyone should employ more healthy lifestyle choices. Simply put, if we treat our bodies better, we are, without too much scientific evidence jargon, going to live longer. While this is true, does it mean that our mental health, per se, will improve, or is more likely to improve over time? Furthermore, if our mental health does improve, and symptoms de-activate over-time, does this mean we will live longer? The study does not evaluate this relationship, either the causal, or proximate circumstances involved and surrounding this question. So, what is this study really evaluating? I would suggest this study is making bigger claims and assertions about the status of a person’s physical health with co-morbid mental health conditions. Thus, the chief complaint or primary problem treated for the pool of this studies participants biggest issue was their physical health problems.
Instead, in very uncertain terms, this study failed to make a real connection between the lifespan of a person and their morbidity unless he or she had a severe psychical complaint as well as a chronic mental health condition. To make this claim, let’s take a quick look at the exclusion criteria. The study excludes people with a worsening or clinical status of in-patient admission in the previous six months. This means, the people in this study were stable, non-symptomatic, and may not require intensive treatment or direction to experience any further improvement and/or relief from their symptoms. So, the people selected for this study are people are living longer because they are already healthy, not because they are receiving groundbreaking treatment and new interventions which work for them. Like I said, we all should strive to be healthier. However, studies like this which make very clear and overreaching claims need to be taken for its true scientific merit. The results of taking studies like this, and similar, as facts, and not something to be interrogated with rigor, will continue to jeopardize the rights of consumers, and perpetuate stereotypes based on medical misinformation and the taking of assumptions as existing evidence.
A Randomized Controlled Trial on the Efficacy of a Psychosocial Behavioral Intervention to Improve the Lifestyle of Patients With Severe Mental Disorders: Study Protocol | Request PDF. Available from: https://www.researchgate.net/publication/325903818_A_Randomized_Controlled_Trial_on_the_Efficacy_of_a_Psychosocial_Behavioral_Intervention_to_Improve_the_Lifestyle_of_Patients_With_Severe_Mental_Disorders_Study_Protocol [accessed Sep 21 2018]
Author Info:
Max E. Guttman
Max E. Guttman is the owner of Mindful Living LCSW, PLLC, a private mental health practice in Yonkers, New York.
