The interface of physical and mental health

Purpose

The interaction between physical and mental health is complex. In this paper we aim to provide an overview of the main components of this relationship and to identify how care could be improved for people with co-morbidities.

Methods

We performed a literature search of MedLine, Ovid and Psycinfo and identified studies that examined the association between mental illness and physical illness. We also examined the key policy documents and guidelines in this area.

Results

People with mental health conditions are at higher risk of developing physical illness, have those conditions diagnosed later and have much higher mortality rates. Conversely, people with a diagnosis of physical illness, especially cardiovascular disease, diabetes and cancer have a greater chance of developing a mental health problem. When both mental and physical illnesses conditions are present together, there are higher overall rates of morbidity, healthcare utilisation, and poorer quality of life.

Conclusions

Physicians and psychiatrists need to be aware of the co-occurrence of mental and physical health problems and the challenges posed for both general and mental health services. There is a need to screen appropriately in both settings to ensure timely diagnosis and treatment. Liaison psychiatry provides psychological assessment and treatment for people with physical illness, but there is a gap in the provision of physical healthcare for people with severe mental illness. There is a need for public policy to drive this forward to overcome the institutional barriers to equitable access to healthcare and for educators to reverse the tendency to teach mind and body as separate systems.