The quiet epidemic

Taking the stage dressed as a nurse, Kylie Harrison plays a very important role during this month’s Mental Health Week. She is Miss Communication, a stand up comic breaking down the stigma associated with mental illness.

“A lot of people have to face mental illness,” Harrison says. “Sometimes with it some people think, ‘should I laugh at this? Are we allowed to laugh at this?’ But I’m saying it in a comical way.”

The irony of miscommunication is not lost on this performer. For 19 years she has lived with bipolar disorder, an illness that formed after receiving the wrong medication for chill blains. Waking from a coma she found her life had transformed forever and from the age of 14 has tried multiple medications, finding the right one just five years ago. While she experienced many medications she found one common side effect.

“When I am on my medication, especially at the start, I will start to crave food all the time and I will especially crave sugar and carbohydrates and just eat, eat, eat,” she says. “I was eating a block of chocolate a day and when I woke up out of my psychosis I am looking in the mirror at a stranger. I have put on 20 kilos and I look different and you just think, ‘what happened?’”

Weight gain from medications is commonly known among those living with mental illness. However it was not until 2006 when Dr Joseph Parks published research in the United States that he revealed an epidemic. By examining mortality rates of people living with serious mental illness he found they were dying 25 years earlier than the general population, and not by suicide.

“Far more people with serious mental illness die of heart disease, hypertension, respiratory illness, diabetes,” Dr Parks says. “If our goal is for people with mental illness to recover and have a full life in the community we have to keep them alive. Nobody recovers from schizophrenia after they are dead from a heart attack at 50.”

While Australia has not made the same statistical analysis our 2010 national survey of psychotic illness provided an alarming snapshot. It too demonstrated that one quarter of people with serious mental illness were at high risk of cardiovascular disease with almost half being obese. Levels of physical activity were also far lower than the general population with 96.4% classified as either sedentary or undertaking low levels of exercise.

These findings propelled the Mental Health Coalition of South Australia into action. Last month they invited Dr Parks to present his findings to both those living with mental illness and the clinicians treating them.

For those living with serious mental illness Dr Parks believes they should educate themselves and question the care and medications they are receiving. However what is really hindering them here in Australia is the lack of communication within our healthcare system. Currently there is no formal system of sharing patient information between general practitioners and their mental healthcare providers.

This mismanagement of information is often at the heart of Harrison’s issues when receiving care. She has had the same psychiatrist since she was a teenager who works in a private practice. Yet when she becomes unwell she has to be treated in the public system. Her patient file is not shared between psychiatrists leaving her to fight for the care and medication she knows she needs. However under Dr Parks’ integrated care model, information about types of medication and why people are taking them is shared. He argues this is imperative as “it’s not reasonable to ask the patient to keep track of that”.

While in Australia Dr Parks met with State and Federal ministers and found the biggest concern over information sharing were our privacy laws. Clinicians he presented to expressed frustration at this and agreed not sharing key information does more harm to the patient.

Acknowledging the next step for Australia’s mental healthcare sector is a policy debate Dr Parks is optimistic for our mental healthcare services.

“What I envy about Australia, that we don’t have as much in the US, is there’s a much stronger general consensus that people should be taking care of each other and that’s something precious you should all hold on to. You really are very generous and supportive of each other and I think that is a great value in keeping people healthy and having long lives.”

Harrison works as a peer worker for Life Without Barriers and uses her own experiences to help people living with mental illness. Her medication keeps her well and she has never felt so good. Yet she admits: “I have to live for today. I can’t worry about 20 years time what will happen but it is scary to not have a back up and that if this [medication] stuffs up then you’re in trouble.”

Miss Communication performs at The Mercury Cinema on Friday, October 12 at 6pm