Mental health approach crucial for combating NCDs

Mental health approach crucial for combating NCDs

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Non-communicable diseases, as opposed to communicable ones, are not contagious since they cannot be transmitted from one person to another.

These conditions are usually long-term, cause death, dysfunction, and impair overall quality of life. Risk factors, such as the person’s lifestyle, heredity and the environment may be responsiblefor developingthese non-communicable diseases.

The diseases are increasingly being recognised as major cause of ill health, disability and death. A World Health Organisation’s report in 2001 indicated that NCDs account for almost 60 per cent of deaths and 46 per cent of the global burden of disease.

Based on current trends, by 2020, these diseases are expected to account for over 70 per cent of deaths and 60 per cent of the disease burden. These conditions include cancers, some heart problems, diabetes and chronic lung diseases.

Non communicable diseases have been established as a clear threat not only to human health but also to development and economic growth. Claiming about 63 per cent of all deaths, these diseases are currently the world’s main killer. Eighty percent of these deaths now occur in low and middle income countries like Nigeria. Half of those who die are in their productive years and thus, the disability imposed and the lives lost are also endangering industry competitiveness across borders.

In 1900, the average life expectancy was about 47years, with very little differences among different countries. The majority of the deaths were due to the rampage of infectious, communicable diseases. During the first half of the 20th century, the industrialised nations of the world made major advances against infectious diseases, with consequent improvement in the average life expectancy.

By the middle of the 20th century, NCDs became a real burden for these developed countries and they were called the diseases of the rich. Developing countries like Nigeria started experiencing the upsurge in the incidence of the NCDs In the last half of the 20th century, attributable to rapid urbanisation, and globalisation of unhealthy lifestyles. Those of us in the developing countries have the greatest vulnerability with the least capacity to cope.

The most reasonable option to reverse this trend is to mitigate the risk factors associated with these diseases. Some of the factors are modifiable, while others are not. The most modifiable is the patient’s lifestyle, which is responsible for over 50 per cent of all NCDs due to drug use, alcohol abuse, tobacco use, diet, lack of exercise and poor management of stress.

The primary causes of death among people with mental illness are circulatory disease, diabetes and obesity traceable to the same unhealthy modifiable lifestyles. Up to 50 per cent of cancer patients suffer from mental health problems such as depression and anxiety; and treating symptoms of depression in them may improve survival rate.

In depressed patients, the risk of a heart attack is more than twice as high as in the general population, just as depression increases the risk of death in patients with cardiac diseases. Stroke is associated with smoking, obesity, hypertension, lack of physical activities and poor diet, which is equally common among several folks with mental illness.

Diabetes is associated with a range of risk factors that include family history, physical inactivity, poor diet and smoking, which explains how diabetes occurs in approximately 15 per cent of people with Schizophrenia, compared with approximately five per cent in the general population. People experiencing mental health problems face stigma, which hinders their access to physical well-being. In the quest to reduce the impact of these non-communicable diseases among the mentally ill, illness-related factors such as help-seeking behaviours, less expression of physical health symptoms due to illness, socio-economic consequences of being mentally ill, poor housing, reduced social networks, lack of employment and social stigma are engaged in health campaigns for this group.

It is absurd, in my opinion, to subsume mental illness under the group of non-communicable diseases rather than the other way round. The mental health paradigm remains the most effective approach in stemming the rise of NCDs in our society. This paradigm will competently engage those risky unhealthy behaviours such as smoking, excessive alcohol consumption, sedentary lifestyles and harmful dietary habits which may be secondary to marital difficulties, career problems, economic downturn, midlife crisis, empty nest syndrome, sudden retrenchment or retirement, bereavement or business failure.

While the physicians can tackle the clinical correlations of these non-communicable diseases, there is the need to identify these at-risk groups before their conditions become irreversible as we facilitate a preventive campaign with a strong mental health paradigm to mitigate the modifiable behavioral risk factors.

This can only be possible when mental health is given its rightful independence and priority in our health policy articulation, since there is really no health without mental health.



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