18.5.1  Nutrition and physical health

People with mental illness may neglect their health. For example, a depressed person might lose interest in food and stop eating, while a person with psychosis might neglect their personal hygiene so that they catch more infections. The presence of mental illness may stop the person noticing symptoms of physical disease and looking for help. People with mental illnesses are also less likely to get adequate treatment for physical health problems. Due to stigma and discrimination, healthworkers may not offer a mentally ill person the same level of treatment they would give to others. For instance, they may not take their physical complaints seriously or they may not investigate them as thoroughly as they would if the patient was not mentally ill.

Additionally, some traditional remedies (e.g. beating out demons) are harmful and may affect the person’s physical health. Practices such as chaining up disturbed people can lead to physical problems, e.g. sores and muscle wasting, so that they become more disabled. Also, people with mental illness are more likely to smoke cigarettes, chew khat and drink alcohol. These habits may negatively affect their physical health.

The unwanted effects of medication (see Study Session 11) can also affect physical health. Some medications can make the person put on a lot of weight and increase their risk of developing diabetes and cardiovascular disease.

Because of all these effects of mental illness on physical health, a person in Ethiopia with severe mental health problems is three times more likely to die young. Here are a few things you can do to help:

• Encourage the family to care for the person with mental illness by giving them shelter, clothing and food, and helping them to care for their personal hygiene.
• Remember that people with mental illness are at higher risk of many physical illnesses. Don’t ignore them if they complain of physical symptoms.
• Monitor their weight to detect undernutrition.
• Monitor carefully for other unwanted effects of medication.
• Explain about the negative effects of drinking alcohol, chewing khat and smoking cigarettes or cannabis.