B1: Holistic health care

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Key point

Key Points

  • People with co-occurring AOD and mental health conditions are at increased risk of physical health problems, with higher mortality rates than the general population.
  • People with co-occurring conditions 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 can deliver the right care, to the right person, at the right time.

The co-occurrence of poor physical and mental health has been well documented; in particular, the role that mental health conditions play in increasing vulnerability to physical disability and poorer outcomes [180–182]. Consumers of mental health services have more than double the mortality rate than the general population [183], largely attributable to CVD [184].

Risk factors for CVD are prominent among people with AOD and mental health conditions [184, 185], and include high rates of smoking [186–188], overweight and obesity [189–191], diabetes [192, 193], poor diet [194, 195], physical inactivity [196–198], excessive alcohol consumption [199, 200], and the use of some antipsychotic medication [201].

Furthermore, these risk factors also place people at risk of metabolic syndrome [202]. Metabolic syndrome is the presence of three or more of the following risk factors [203]:

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

Approximately one third of Australians have metabolic syndrome [204], which is directly affected by sleep, physical activity, and dietary behaviours [205, 206]. People with mental disorders (e.g., schizophrenia, bipolar disorder, depression, PTSD, BPD) are at high-risk of metabolic syndrome and associated morbidity and mortality, particularly those prescribed antipsychotics [202, 205, 207, 208].