People living with psychotic illness in 2010: The second Australian national survey of psychosis

Abstract

Objective: The 2010 Survey of High Impact Psychosis (SHIP) is Australia’s second national psychosis survey. This paper provides an overview of its findings, including comparisons with the first psychosis survey and general population data. Methods: The survey covered 1.5 million people aged 18–64 years, approximately 10% of Australians in this age group. A two-phase design was used. In phase 1, screening for psychosis took place in public mental health services and non-government organizations supporting people with mental illness. In phase 2, 1825 of those screen-positive for psychosis were randomly selected and interviewed. Data collected included symptomatology, substance use, functioning, service utilization, medication use, education, employment, housing, and physical health including fasting blood samples. Results: The estimated 1-month treated prevalence of psychotic disorders in public treatment services was 3.1 people per 1000 population; the 12-month treated prevalence was 4.5 people per 1000. The majority (63.0%) of participants met ICD-10 criteria for schizophrenia/schizoaffective disorder. One-half (49.5%) reported attempting suicide in their lifetime and two-thirds (63.2%) were rated as impaired in their ability to socialize. Over half (54.8%) had metabolic syndrome. The proportion currently smoking was 66.1%. Educational achievement was low. Only 21.5% were currently employed. Key changes in the 12 years since the first survey included: a marked drop in psychiatric inpatient admissions; a large increase in the proportion attending community mental health clinics; increased use of rehabilitation services and non-government organizations supporting people with mental illness; a major shift from typical to atypical antipsychotics; and large increases in the proportions with lifetime alcohol or drug abuse/dependence. Conclusion: People with psychotic illness face multiple challenges. An integrated approach to service provision is needed to ensure that their living requirements and needs for social participation are met, in addition to their very considerable mental and physical health needs.

Australia's Health Care Homes: laying the right foundations

“…Concurrently, the poor management of the often multi-morbid physical conditions of people with severe and complex mental illness (many of which can be managed in primary health care) is a major factor in their reduced life expectancy. Around one third of people (31.8%) with a psychotic disorder in Australia are also experiencing chronic pain, around a fifth (20.8%) have diabetes -over three times the rate of the general population -and just over a quarter (26.8%) have heart or circulatory problems [4].…”

“…• people with severe mental illness and Aboriginal and Torres Strait Islander peoples are three times more likely than the general population to have diabetes and are at increased risk of cardiovascular disease [4,5]; and • risk factors for chronic conditions, such as obesity, are at high levels and increasing and will inevitably drive growth in rates of diabetes and other preventable conditions over time [6] [7].…”

Impact of care coordination on Australia's mental health service delivery system

“…12 Strong current evidence for the problems in case management is located in the recent Survey of High Impact Psychosis (SHIP). 13 According to the National Standards for Mental Health Services, 14 the development and regular review of a treatment, care and recovery plan in consultation with each consumer is an expectation of both non-government organisations and public community mental health services. If an assumption is accepted that good case management is reflected in collaborative treatment planning involving consumers and their families, then the SHIP data suggest that this is an inconsistent feature of Australia's mental health services.…”

General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial

“…17,18 For example, people with SMI are less likely to receive appropriate medications, such as beta-blockers and statins following myocardial infarction, 17 even though their physician consultation rates are generally high. 14,19,20 Although patient-based factors may be a partial explanation for these findings, it is also likely that the attitudes of health professionals, inefficient organisation of health services and social stigma are also contributing factors. 21 Thus, poor access, an absence of integration between elements of the system and poor quality care all contribute to the poor physical health of this population.…”