“LSomatic care for patients with mental disorders is very poor. I’ll give just one figure: today only 30% of them have a general practitioner, although very often they have concomitant diseases.”
The coordinator of somatic care at the Sainte-Marie hospital center in Nice, Jean-Didier Eberhardt, makes no detours to condemn an unacceptable situation that he has already been able to fully appreciate in his twenty years of practice as a general practitioner.
Although he admits it’s not easy to take control in a Liberal government “People with mental disorders who may sometimes be agitated or impatient…”it points out the consequences of lack of care.
“Even at the dental level, these patients often suffer from severe abscesses, partial or even complete edentulism, severe pain… we find catastrophic situations!”
Boomerang effect: refusal to treat somatic pathologies leads to… an increase in mental disorders!
“It is estimated that 30% of the states of agitation observed in averbal patients in particular, or those suffering from autism, deficit psychosis, are directly caused by untreated physical symptoms.”
Very actual pain
If dental problems are among the pathologies most often found in patients with mental disorders, then the list of their other ailments is, unfortunately, very long: “Pulmonary pathologies – a type of COPD – and cardiovascular pathologies due to excess weight and smoking, cardiotoxic effects of certain treatments, transit problems, with the risk of intestinal obstruction caused by both a sedentary lifestyle and chronic medication use, pain in the joints, malnutrition… Not to mention, of course, the pain and headaches caused by certain medications…”lists Dr. Eberhardt.
The barriers to effective treatment of physical disorders in these patients are numerous: stigma, lack of knowledge about the characteristics of mental illness, general shortage of caregivers, insufficient allocated resources, etc.
“When we need a simple test like a CT scan for a patient, we often find ourselves helpless. Who can carry out these procedures, knowing that sometimes it is necessary to carry them out under anesthesia, that this takes a lot of time…? We often have to go through the hospital…”
Another obstacle: certain preconceived ideas. And Dr. Eberhardt cites a case of pain among polydrug addicts. “It is generally accepted that treating them with codeine or other painkillers such as morphine is dangerous because they risk becoming dependent on these drugs, but this is inhumane. They need to be treated when they hurt! By giving them these molecules – of course, in a very controlled way – we, on the contrary, reduce their consumption of toxicants.”
If we had to finally convince people of the urgency of studying this topic, it would be enough to remember that“A person with a chronic mental disorder lives on average 10 to 15 years less than the rest of the population.”
You can point to the significant (and necessary) consumption of medications, lack of prevention, smoking (patients with schizophrenia, for example, smoke twice as many cigarettes per day as other smokers), high suicide rates, etc.
But neglecting some of the care for physical illnesses means for health policy to abdicate its responsibilities.