March 28th is National Diabetes Alert Day, an important opportunity to raise awareness about the prevalence of diabetes and a call to action for individuals to take charge of their health and assess their risk for diabetes. Mental health conditions and physical health ailments are often interconnected. Individuals with mental illness are at a higher risk of developing physical health problems, including diabetes. For example:
· The National Institute of Mental Health (NIMH) reports that people with serious mental illness (SMI) are 2 to 3 times more likely to have type 2 diabetes than the general population.
· A meta-analysis of 42 studies found that people with SMI have a 109% higher prevalence of diabetes than the general population. (Osborn, Levy, et al. Relative risk of diabetes, dyslipidemia, hypertension and the metabolic syndrome in people with severe mental illnesses: systematic review and meta analysis. BMC Psychiatry. 2008;8:84. doi:10.1186/1471-244X-8-84)
The link between mental health and diabetes is complex and multi-faceted. Some contributing factors include poor nutrition, certain medications used to treat mental illness, limited access to care, and lack of physical activity. Additionally, the stress of managing a mental illness can lead to poor self-care, which can further increase the risk of developing diabetes.
POOR NUTIRTION HABITS
Adults with mental illness are at an increased risk for poor nutrition habits that can lead to diabetes for a variety of reasons:
· Poverty and Food Insecurity: Adults with mental illness are more likely to have limited incomes, which can limit access to healthy foods and increase reliance on low-cost, high-calorie, and nutrient-poor options.
· Poor self-care: Adults with mental illness may struggle with self-care, including maintaining healthy eating habits. Symptoms of mental illness such as depression, anxiety, and apathy can make it difficult to prioritize and maintain healthy behaviors.
· Cognitive limitations: Many adults with mental illness may have cognitive limitations, such as difficulty with memory, attention, and decision-making. These limitations can make it harder for individuals to plan and prepare healthy meals, remember to eat regularly, and make healthy choices when it comes to food.
· Independent living skills limitations: Adults with mental illness may have limitations in independent living skills such as cooking, meal planning, budgeting and grocery shopping. These limitations can contribute to a reliance on pre-packaged, processed, and fast foods, which are often high in calories, unhealthy fats, and sugar.
· Mental status struggles: Mental status struggles such as insight, judgement, and impulse control can all affect an individual's ability to make healthy choices when it comes to food. For example, individuals with poor impulse control may be more likely to indulge in high-calorie, high-sugar foods, while those with limited insight or judgement may struggle to recognize the importance of healthy eating habits.
ANTIPSYCHOTIC MEDICATIONS
Antipsychotic medications, commonly used to treat schizophrenia, bipolar disorder and other mental health disorders, have been associated with an increased risk of type 2 diabetes. For example:
· Clozapine has been associated with a high risk of diabetes. One study found that 25% of people taking clozapine developed diabetes within 1 year of treatment. (American Diabetes Association)
· Olanzapine has been shown in studies to cause significant weight gain, which is a major risk factor for diabetes. (National Institute of Mental Health)
· Risperidone has also been shown in studies to cause significant weight gain and alter insulin sensitivity, leading to an increased risk of diabetes. (American Diabetes Association)
· Quetiapine has been shown in studies to significant weight gain and alter glucose metabolism, leading to an increased risk of diabetes. (National Institute of Mental Health)
ACCESS TO CARE
People with SMI often experience barriers to accessing healthcare and may not receive the same level of medical care as the general population, which can contribute to a higher risk of developing diabetes. According to the National Alliance on Mental Illness (NAMI), individuals with mental illness are less likely to receive routine medical care, including preventive screenings for conditions like diabetes, than those without mental illness. This can lead to delays in diagnosis and treatment of diabetes, which can lead to more severe health complications over time. For example:
· Stigma: According to a study published in the Journal of General Internal Medicine, stigma can prevent individuals with mental illness from seeking medical care.
· Transportation: According to a study published in Psychiatric Services, lack of transportation was cited as a significant barrier to accessing medical care among individuals with mental illness.
· Financial: According to a study published in the Journal of Mental Health Policy and Economics, individuals with mental illness are more likely to be uninsured or underinsured than the general population, which can impact their ability to obtain medical care.
LACK OF PHYSICAL ACTIVITY
Adults with mental illness experience a lack of physical activity relative to the general population due to several factors, including limited access to exercise facilities, and negative symptoms associated with mental illness such as fatigue and low motivation. This lack of physical activity can contribute to an increased risk of developing diabetes and other chronic health conditions.
· According to a study published in the American Journal of Preventive Medicine, individuals with serious mental illness on average engage in significantly less moderate-to-vigorous physical activity per week than the recommended 150 minutes per week for general health.
· Medication side effects can contribute to decreased energy levels, making it difficult for individuals with mental illness to engage in physical activity. Certain antipsychotic medications, for example, have been associated with weight gain and increased risk of diabetes.
· Limited access to exercise facilities can also contribute to a lack of physical activity among individuals with mental illness. According to a study published in Psychiatric Services, individuals with mental illness reported lower levels of access to exercise facilities and equipment compared to the general population.
WHAT WE’RE DOING TO HELP
Addressing the physical health needs of people with mental illness is important for improving overall health outcomes and reducing healthcare costs. Studies have shown that integrated care programs that address both mental and physical health have been effective in improving health outcomes for individuals with SMI. (Druss BG, Rohrbaugh RM, Levinson CM, Rosenheck RA. Integrated medical care for patients with serious psychiatric illness: a randomized trial. Arch Gen Psychiatry. 2001;58(9):861-868. doi:10.1001/archpsyc.58.9.861)
As Arizona’s largest Personal-Care Certified Behavioral Health Residential Facility, Orion Homes is uniquely positioned to meet the needs of adults with mental illness who are also struggling with co-morbid physical health conditions like diabetes. Our holistic approach to wellness can improve both mental and physical health outcomes for individuals with mental illness. This includes a comprehensive treatment plan that addresses all aspects of health, including physical, emotional, and social well-being.
· Addressing poor nutrition habits by promoting access to healthy foods and education on nutrition can help improve the health outcomes of adults with mental illness. Orion Homes works with a Registered Dietician to develop a heart-healthy menu for all Residents. We educate Residents on portion size, nutritional information, and healthy snack substitutions.
· Encouraging physical activity and providing access to exercise facilities and equipment can help mitigate this risk caused by lack of exercise. Orion Homes…
· Regular health check-ups are essential to monitor health changes, screen for conditions like diabetes, and develop a proactive plan for managing physical health. Orion Homes’ care team includes a full-time Registered Nurse who follows our Residents and monitors their chronic and emerging physical health needs. We also work closely with outside medical professionals; a member of our team attends each appointment with our Residents to ensure accurate and complete information is shared with the provider, and to ensure all the provider’s recommendations are understood and followed up on.
The link between mental health and diabetes is complex and multi-factorial. A holistic approach to wellness that addresses all aspects of health can improve both mental and physical health outcomes for individuals with mental illness. Strategies for managing both mental and physical health include regular health check-ups, healthy eating habits, physical activity, and collaborating with healthcare professionals to provide integrated care. By prioritizing a comprehensive approach to wellness, we can improve the lives of individuals with mental illness and reduce the risk of developing physical health problems like diabetes.
At Orion Homes, we believe that everyone deserves the opportunity to live a healthy and fulfilling life, regardless of the challenges they face. If you or someone you know is struggling with managing diabetes due to a mental health condition, we want to help. Our team is dedicated to providing the right care and support to help individuals with diabetes and mental health conditions manage their health and achieve their goals. We offer a range of services and programs tailored to the unique needs of each individual, including medication management, counseling, and physical activities. By reaching out to Orion Homes, you can take the next step towards better health and a better life. Let us help you manage your diabetes and improve your quality of life.
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