From the Editor
When people with mental health problems have physical illness, how does their care measure up?
Not surprisingly, we worry about their access and follow up. Evidence suggests poorer outcomes. But how do people with mental disorders fare on an international basis?
In the first selection, Dr. Marco Solmi (of the University of Padua) and his co-authors try to answer that question, focusing on cardiovascular diseases (CVD). In a new American Journal of Psychiatry paper, they conduct a systematic review and meta-analysis, drawing on the data of more than 24 million people. (!) They find: “People with mental disorders, and those with schizophrenia in particular, receive less screening and lower-quality treatment for CVD. It is of paramount importance to address underprescribing of CVD medications and underutilization of diagnostic and therapeutic procedures across all mental disorders.” We discuss the paper and its clinical implications.
In the second selection from The American Journal of Psychiatry, Drs. Nathalie Moise and Sidney Hankerson (both of Columbia University) consider structural racism and depression care, using a clinical vignette. Rather than just seeing the patient’s experience in terms of genetic loading and medications, they describe a person who has struggled with various forms of racism. They argue: “Mental health professionals need to recognize the effect of structural, individual, and internalized racism on individuals with depression symptoms.”