Limits...
The trend in mental health-related mortality rates in Australia 1916-2004: implications for policy.

Doessel DP, Williams RF, Whiteford H - Aust New Zealand Health Policy (2010)

Bottom Line: Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics.First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here.This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector.

View Article: PubMed Central - HTML - PubMed

Affiliation: Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt, Australia.

ABSTRACT

Background: This study determines the trend in mental health-related mortality (defined here as the aggregation of suicide and deaths coded as "mental/behavioural disorders"), and its relative numerical importance, and to argue that this has importance to policy-makers. Its results will have policy relevance because policy-makers have been predominantly concerned with cost-containment, but a re-appraisal of this issue is occurring, and the trade-off between health expenditures and valuable gains in longevity is being emphasised now. This study examines longevity gains from mental health-related interventions, or their absence, at the population level. The study sums mortality data for suicide and mental/behavioural disorders across the relevant ICD codes through time in Australia for the period 1916-2004. There are two measures applied to the mortality rates: the conventional age-standardised headcount; and the age-standardised Potential Years of Life Lost (PYLL), a measure of premature mortality. Mortality rates formed from these data are analysed via comparisons with mortality rates for All Causes, and with circulatory diseases, cancer and motor vehicle accidents, measured by both methods.

Results: This study finds the temporal trend in mental health-related mortality rates (which reflects the longevity of people with mental illness) has worsened through time. There are no gains. This trend contrasts with the (known) gains in longevity from All Causes, and the gains from decreases achieved in previously rising mortality rates from circulatory diseases and motor vehicle accidents. Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics.

Conclusions: There are several factors that could reverse this trend. First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here. Second, it is important also that new efficacious therapies for various mental disorders be developed. Furthermore, it is also important that suicide prevention strategies be implemented, particularly for at-risk groups. To bring the mental health sector into parity with many other parts of the health system will require knowledge of the causative factors that underlie mental disorders, which can, in turn, lead to efficacious therapies. As in any case of a knowledge deficit, what is needed are resources to address that knowledge gap. Conceiving the problem in this way, ie as a knowledge gap, indicates the crucial role of research and development activity. This term implies a concern, not simply with basic research, but also with applied research. It is commonplace in other sectors of the economy to emphasise the trichotomy of invention, innovation and diffusion of new products and processes. This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector.

No MeSH data available.


Related in: MedlinePlus

Age-standardised mortality rates for (a) total mortality (all causes combined), and (b) circulatory diseases, cancers, mental health-related mortality and motor vehicle accidents, Australia, persons, 1907-2004. * These rates have been standardised to the age distribution of the 1991 Australian population. ‡ Mental-Related Mortality includes Mental/Behavioural Disorders and Suicide. Sources: AIHW[23], CBCS [46-49], Taylor[52]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2818650&req=5

Figure 1: Age-standardised mortality rates for (a) total mortality (all causes combined), and (b) circulatory diseases, cancers, mental health-related mortality and motor vehicle accidents, Australia, persons, 1907-2004. * These rates have been standardised to the age distribution of the 1991 Australian population. ‡ Mental-Related Mortality includes Mental/Behavioural Disorders and Suicide. Sources: AIHW[23], CBCS [46-49], Taylor[52]

Mentions: Figure 1 puts the mental health-related mortality trend in perspective by presenting a line graph of the All Causes mortality rate as well as comparative mortality rates associated with some causes of death, viz. mental health-related (as defined here), cancer, circulatory diseases and motor vehicle accidents. Given the large differences in age-standardised rates, the figure has two parts, Part (a) showing a long-run decrease in the All Causes mortality rate. This reflects the experience of many countries. Some argue that the nineteenth century witnessed a transition phase, and then a period of virtually continuous decline in mortality, and that this trend is an "epidemiological transition" or a "demographic transition" [60-63]. Part (b) depicts the mortality rates for four specific causes: circulatory diseases; cancers; motor vehicle accidents; and mental health-related.


The trend in mental health-related mortality rates in Australia 1916-2004: implications for policy.

Doessel DP, Williams RF, Whiteford H - Aust New Zealand Health Policy (2010)

Age-standardised mortality rates for (a) total mortality (all causes combined), and (b) circulatory diseases, cancers, mental health-related mortality and motor vehicle accidents, Australia, persons, 1907-2004. * These rates have been standardised to the age distribution of the 1991 Australian population. ‡ Mental-Related Mortality includes Mental/Behavioural Disorders and Suicide. Sources: AIHW[23], CBCS [46-49], Taylor[52]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2818650&req=5

Figure 1: Age-standardised mortality rates for (a) total mortality (all causes combined), and (b) circulatory diseases, cancers, mental health-related mortality and motor vehicle accidents, Australia, persons, 1907-2004. * These rates have been standardised to the age distribution of the 1991 Australian population. ‡ Mental-Related Mortality includes Mental/Behavioural Disorders and Suicide. Sources: AIHW[23], CBCS [46-49], Taylor[52]
Mentions: Figure 1 puts the mental health-related mortality trend in perspective by presenting a line graph of the All Causes mortality rate as well as comparative mortality rates associated with some causes of death, viz. mental health-related (as defined here), cancer, circulatory diseases and motor vehicle accidents. Given the large differences in age-standardised rates, the figure has two parts, Part (a) showing a long-run decrease in the All Causes mortality rate. This reflects the experience of many countries. Some argue that the nineteenth century witnessed a transition phase, and then a period of virtually continuous decline in mortality, and that this trend is an "epidemiological transition" or a "demographic transition" [60-63]. Part (b) depicts the mortality rates for four specific causes: circulatory diseases; cancers; motor vehicle accidents; and mental health-related.

Bottom Line: Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics.First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here.This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector.

View Article: PubMed Central - HTML - PubMed

Affiliation: Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt, Australia.

ABSTRACT

Background: This study determines the trend in mental health-related mortality (defined here as the aggregation of suicide and deaths coded as "mental/behavioural disorders"), and its relative numerical importance, and to argue that this has importance to policy-makers. Its results will have policy relevance because policy-makers have been predominantly concerned with cost-containment, but a re-appraisal of this issue is occurring, and the trade-off between health expenditures and valuable gains in longevity is being emphasised now. This study examines longevity gains from mental health-related interventions, or their absence, at the population level. The study sums mortality data for suicide and mental/behavioural disorders across the relevant ICD codes through time in Australia for the period 1916-2004. There are two measures applied to the mortality rates: the conventional age-standardised headcount; and the age-standardised Potential Years of Life Lost (PYLL), a measure of premature mortality. Mortality rates formed from these data are analysed via comparisons with mortality rates for All Causes, and with circulatory diseases, cancer and motor vehicle accidents, measured by both methods.

Results: This study finds the temporal trend in mental health-related mortality rates (which reflects the longevity of people with mental illness) has worsened through time. There are no gains. This trend contrasts with the (known) gains in longevity from All Causes, and the gains from decreases achieved in previously rising mortality rates from circulatory diseases and motor vehicle accidents. Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics.

Conclusions: There are several factors that could reverse this trend. First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here. Second, it is important also that new efficacious therapies for various mental disorders be developed. Furthermore, it is also important that suicide prevention strategies be implemented, particularly for at-risk groups. To bring the mental health sector into parity with many other parts of the health system will require knowledge of the causative factors that underlie mental disorders, which can, in turn, lead to efficacious therapies. As in any case of a knowledge deficit, what is needed are resources to address that knowledge gap. Conceiving the problem in this way, ie as a knowledge gap, indicates the crucial role of research and development activity. This term implies a concern, not simply with basic research, but also with applied research. It is commonplace in other sectors of the economy to emphasise the trichotomy of invention, innovation and diffusion of new products and processes. This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector.

No MeSH data available.


Related in: MedlinePlus