THE MENTALLY ILL: Less Likely To Receive Cardiac Care
Patients with mental illness are less likely to receive treatment for heart disease than those without mental disorders, according to a study published today in the Journal of the American Medical Association. Researchers at the Yale University School of Medicine studied 113,653 heart patients, including 5,653 with mental illness, and found that patients with mental disorders were 25% less likely to receive angioplasty procedures, 32% less likely to undergo coronary bypass surgery and 28% less likely to undergo cardiac catheterization. Dr. Benjamin Druss, assistant professor of psychiatry at Yale, said, "Patients with mental disorders are a vulnerable population who may be vulnerable to inadequate medical care. Further work is needed to better understand factors leading to these differences and their implications for quality and long-term outcomes of their cardiac care." Druss said that the differences were not due to severity of illness, the hospital conducting treatment or regional differences between groups (Hathaway, Hartford Courant, 1/26). Druss added, "These differences in procedure rates could be used as a marker for potentially larger difficulties in the health care system. They are a red flag that we need to look at the issue more carefully." Specifically, researchers pointed to the attitudes of both mental patients and their doctors as possible factors in the disparities. Some mental patients might dismiss a doctor's recommendation or be unable to provide informed consent about treatment. Doctors, researchers said, might fear that mental patients could not comply with treatment regimens or might believe that patients with mental illness are "less deserving of care" (Tanner, AP/Boston Globe, 1/26).
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