Annual surveys of the public’s attitudes to mental illness in England have been running for nearly 20 years and the most recent report makes interesting reading.
Compared to 1994 the number of people agreeing that “mental illness is an illness like any other” has increased from 71% to 77%. The percentage saying they would be comfortable talking to a friend or family member about their mental health has also increased and now stands at 70%.
Mild mental illness, anxiety and depression are common in all long term conditions and chronic kidney disease is no different. Mental illness significantly affects the quality of life of people with kidney disease but this is not yet well recognised. About a half of dialysis patients who are breathless on exertion or nauseated are correct identified by their doctors and nurses – that doesn’t sound great does it? But only a meagre 17% of those that are feeling sad and just 6% of those who are anxious or who have a reduced interest in sex are picked up in routine care, despite the fact that 40-50% of patients who are on dialysis or who have been transplanted experience anxiety or depression. What’s more, depression is associated with more hospitalisation, greater physical symptom burden and worse outcomes. This is really sad as there are very effective treatments for depression ranging from exercise, change in dialysis regime, talking therapies and medication. We should be talking, researching and doing more about it in the kidney world.
Of course mental illness is common in the general population as well. In the survey the majority of respondents (57%) reported that someone close to them had some kind of mental illness. Stigma and discrimination still remain a major issue. Half said they experienced a lot of discrimination and this hasn’t changed much in the last couple of years. That’s a pretty disappointing statistic and while a natural reaction to the fact that 21% of people feel anyone with a history of mental illness should be excluded from taking public office might be to smile or joke, it shouldn’t be because there’s a darker side. One in 8 feel that those with mental illness should not be given any responsibility and the same proportion that it would be foolish to marry someone who has had any mental illness in the past, even if they have made a full recovery.
Now that there is a definititive focus on patient experience in health and healthcare, how people with kidney disease or other chronic illnesses feel should be studied, recorded and firmly on the agenda.