Holistic health care

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Key Points

  • People with comorbid AOD and mental health conditions are at increased risk of physical health problems, with higher mortality rates than the general population.
  • Those with comorbidity are at particular risk of developing CVD, due to high rates of smoking, overweight and obesity, diabetes, poor diet, physical inactivity, high alcohol consumption, and the use of some antipsychotic medications.
  • Recent research has highlighted the need for interventions that focus on overall wellbeing, including reducing smoking, improving dietary habits, increasing physical activity, and sleep patterns.
  • Crucial to this approach is the inclusion of multiple service providers who reflect the complex needs of clients, and are able to deliver the right care, to the right person, at the right time.

Holistic Health Care

The co-occurrence of poor physical and mental health has been well documented in recent years, with greater attention paid to the role that mental health plays in increasing vulnerability to physical disability and poorer outcomes [126-130]. Consumers of mental health services have more than double the mortality rate than the general population [126], especially due to CVD [131].

Risk factors for CVD are prominent among people with AOD and mental health conditions [132]. These include high rates of smoking [133-135], overweight and obesity [136-138], diabetes [127], poor diet [131, 139, 140], physical inactivity [141-143], excessive alcohol consumption [144], and use of some antipsychotic medication [130].

Furthermore, these risk factors also place individuals at risk for metabolic syndrome. Metabolic syndrome is the presence of three or more of the following risk factors [145]:

  • Elevated waist circumference (or central obesity).
  • Raised triglycerides.
  • Increased blood pressure.
  • Increased glucose.
  • Lowered high-density lipoprotein cholesterol.

One third of Australians are currently diagnosed with metabolic syndrome [146], which has been found to be directly affected by sleep, physical activity, and dietary behaviours [147, 148]. Research has found that people with mental health disorders (e.g., schizophrenia, bipolar disorder, depression, PTSD, BPD) should be considered a high-risk group for metabolic syndrome and associated morbidity and mortality, particularly those prescribed antipsychotics [149-152].