SAMHSA study offers more evidence linking mental and physical illness

A new report shows that adults (aged 18 and older) who had a mental illness in the past year have higher rates of certain physical illnesses than those not experiencing mental illness. According to a report by the Substance Abuse and Mental Health Services Administration (SAMHSA), adults aged 18 and older who had any mental illness, serious mental illness, or major depressive episodes in the past year had increased rates of high blood pressure, asthma, diabetes, heart disease, and stroke.

For example, 21.9% of adults experiencing any mental illness (based on the diagnostic criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)) in the past year had high blood pressure. In contrast, 18.3% of those without experiencing any mental illness had high blood pressure. Similarly, 15.7% of adults who had any mental illness in the past year also had asthma, while only 10.6% of those without mental illness had this condition.

Adults who had a serious mental illness (i.e., a mental illness causing serious functional impairment substantially interfering with one or more major life activities) in the past year also evidenced higher rates of high blood pressure, asthma, diabetes, heart disease, and stroke than people who did not experience serious mental illnesses.

Adults experiencing major depressive episodes (periods of depression lasting two weeks or more in which there were significant problems with everyday aspect of life such as sleep, eating, feelings of self-worth, etc.) had higher rates of the following physical illnesses than those without past-year major depressive episodes: high blood pressure (24.1% vs. 19.8%), asthma (17.0% vs. 11.4%), diabetes (8.9% vs. 7.1%), heart disease (6.5% vs. 4.6%), and stroke (2.5% vs. 1.1%).

The report also shows significant differences in emergency department use and hospitalization rates in the past year between adults with past-year mental illness and those without. For example, 47.6% of adults with serious mental illness in the past year used emergency departments as opposed to only 30.5% of those without past-year serious mental illness. Adults with past-year serious mental illness were more likely to have been hospitalized than those without past-year serious mental illness (20.4% versus 11.6% respectively).

“Behavioral health is essential to health. This is a key SAMHSA message and is underscored by this data,” said SAMHSA Administrator Pamela S. Hyde. “Promoting health and wellness for individuals, families and communities means treating behavioral health needs with the same commitment and vigor as any other physical health condition. Communities, families, and individuals cannot achieve health without addressing behavioral health.”

To that end, since 2009 SAMHSA has funded the Primary and Behavioral Health Care Integration (PBHCI) program, which works to improve the physical health status of people with serious mental illness and those with co-occurring substance use disorders by supporting community efforts to coordinate and integrate primary care services into publicly funded community-based behavioral health settings.

Currently 64 community behavioral health providers receive the PBHCI grant, with the expected outcome of entering into partnerships to develop or expand their offering of primary healthcare services, resulting in improved health status for their clients. As of March 2012, over 17,500 adults with serious mental illness and/or co-occurring substance use disorders have been served via the PBHCI program.

More information about the PBHCI program is available at https://www.integration.samhsa.gov/about-us/pbhci.

SAMHSA's Wellness Initiative  builds on the HHS Million Hearts campaign and promotes wellness for people with mental and substance use disorders by motivating individuals, organizations, and communities to take action and work toward improved quality of life, cardiovascular health, and decreased early mortality rates.

For more information, visit www.samhsa.gov/wellness.