New York – Over many years, studies have highlighted how mental health and behaviors affect physical health. Intertwined with this concept we’ve seen new frontiers with behavioral economics, including motivational behavior, navigating biases and irrational behavior. While these aspects have made an incredible impact on how pharmaceutical companies, doctors and patients are engaging with each other, more often than not, mental health is overlooked with regards to patient outcomes outside of biases towards hypochondria. We see that the effects of mental health on the body often aren’t top of mind for patients, companies and doctors.
To underscore the importance of this consideration, let’s first put a spotlight on some of the facts around how mental health relates to physical health, including examples related to specific disease states:
- Depression combined with physical illness is not diagnosed as successfully as depression occurring on its own. This is because health professionals are understandably concerned with the physical disorder that is usually the reason for the consultation and may not be aware of the accompanying depression.
- Patients with chronic diseases are more likely to feel psychological distress than healthy individuals do, with reports indicating that the rate of depression in these patients is almost three times higher.
- One study highlighted the fact that for arthritis patients, treating depression alleviated pain intensity from their arthritis, which in turn allowed them greater ability to engage in activities and helped them achieve a better quality of life overall.
- Even if a patient’s prognosis for survival is poor, active treatment of depression can help improve quality of life.
- With regards to self-rated distress, patients with the highest levels were 32% more likely to have died from cancer.
- Some diseases, such as psoriasis, are triggered by stress. In the UK, alone, it’s been reported that around one-third of patients experience anxiety and depression and 1 in 10 contemplate suicide.
- Depression is considered a risk factor for both cancer and heart diseases. Patients with comorbid depression (a combination of depression and physical illness) also have increased risk of mortality and disability.
- Anxiety, depression and substance use in patients, with diseases that manifest physically, may cause a lack of adherence to treatment.
- Globally, 27% of diabetes patients, up to 29% of hypertension patients, up to 31% of stroke patients, and up to 30% of epilepsy patients have a prevalence of depression compared to 10% of the general population.
Now let’s look at some of the statistics on mental health care:
- According to the World Health Organization, over 30% of countries globally have no mental health program, while 40% have no mental health policies in general.
- For 16.4% of countries, mental health care was primarily an out-of-pocket expenditure, and in the U.S., studies show that 17% of the population have had to choose between treatment of mental health or their physical health condition due to limitations of their insurance policies.
- Additionally, globally where individuals have insurance, health plans often do not cover mental health care to the same extent as physical disorders, creating financial issues for patients and caregivers. In fact, a quarter of Americans have had to choose between mental health care or paying for their daily needs.
- Globally, it’s been noted that there are not enough doctors and nurses that understand how to identify and effectively treat mental disorders. This may partly due to the fact that 41% of countries have no mental health training for primary care providers.
- Close to half of the people in the U.S. have seen either themselves or someone they know drive over an hour to seek mental health treatment. In one study, it was shown that 74% of Americans do not find mental health care accessible, despite the growing demand.
What is being done about it?
Some companies have seen the care gap for patients and have made conscious efforts to alleviate this unmet need. One such example is Sanofi’s partnership with Happify Health. This initiative aims to improve mental health for thousands of multiple sclerosis patients. According to one Sanofi representative, the company chose to focus on MS because of its experience and expertise with the disease, implying that this initiative could expand to other disease states. In this case, Sanofi recognized that MS patients are two to five times more likely to develop depression versus the general population. Currently, several thousand MS patients are engaged in a trial version of the app, which Sanofi intends to submit to the FDA for classification as a medical device.
Additionally, groups like Chicago-area Advocate Health Care are focusing their practice on managing mental health comorbidity alongside medical diagnoses. Christiana Care has mental health specialists integrated within many of its primary care practices, in addition to one specialty-care practice, and has expanded this program throughout their cancer, cardiac, ICU, and pediatric care programs.
While these three examples demonstrate some progress within this space, there’s significantly more to be done. Many pharmaceutical companies may have opportunity to enhance quality of life for patients by exploring opportunities with mental health as it relates to patient support. This could mean things like helping patients find support, but also helping doctors and nurses be better equipped to recognize mental health symptoms. As we move forward, there are an increased number of challenges and barriers that create an unmet need. As we can see from the statistics, addressing mental health as it relates to physical health, with regards to comorbidities and chronic disease, will be an important opportunity to act on.