Psychiatric Services in Advance

1 Persons with serious mental illness suffer from increased rates of comorbidity and die, on average, 25 years earlier than persons in the general population (1). Such morbidity has prompted searches for remedies, which have focused both on patients’ lifestyle (for example, smoking) and clinical practice (for example, physician-directed action). According to one recent study, compared with patients without mental health indications, psychiatric patients are more likely to smoke and be sedentary, and they have a threefold increased incidence of mortality (2). Even after adjustment for smoking and exercise, a twofold increase in mortality persists, indicating that other factors substantially influence the health of persons with mental illness. Poor general medical care is an important correlate of morbidity among populations with mental illness (3). Among Medicare enrollees, use of referral-sensitive surgery, such as insertion of an artificial pacemaker, was lower among persons with mental illness than among those in a control group without mental illness (4). Beren and others (5) found that Arizona Medicaid enrollees with mental illness consumed fewer general medical resources, in 1999 dollars, than those in a control group ($1,431 versus $1,750), despite higher rates of emergency department use. Moreover, delayed care was reflected in Cervical Cancer Screening and Acute Care Visits Among Medicaid Enrollees With Mental and Substance Use Disorders