According to new research in South Africa, mental health may play a more significant role in the process of recovering from physical illnesses than traditionally acknowledged by patients and healthcare systems.
An analysis conducted by Health Quality Assessment (HQA) based on insurance payment data revealed a relatively high prevalence of anxiety, as well as a high rate of readmissions among patients with depression and gaps in documented follow-up care after discharge from hospitals for mental disorders.
HQA warned that the collected data do not explain the causes of these gaps or prove their responsibility for readmissions; however, they indicated the need for further study into the continuity of care after hospitalization.
These findings were presented at the 22nd annual HQA conference on industry outcomes and clinical quality, where psychologist Christine Critzas from The Lighthouse delivered the keynote address on the relationship between mental and physical health.
Critzas noted the shocking statistic: 'Every 40 seconds someone dies by suicide.'
The Mind-Body Connection
Critzas emphasized that the interaction between mind and body is bidirectional. She described this synergy as the influence of mental state on physiology, affecting the brain, nervous system, hormones, and immune system.
According to her, stress can affect cortisol levels, inflammation, and sleep, while health problems can, in turn, negatively impact a person's mental state. For example, 'one bad night's sleep can determine how emotionally reactive you will be the next day.'
Critzas cited World Health Organization data showing that one in four people experiences mental health problems. She also reported that the number of cases of anxiety and depression has sharply increased since the pandemic, affecting over 970 million people worldwide. Furthermore, studies show that depression can increase the risk of cardiovascular diseases by approximately 40% to 60%.
The Physical Burden
The expert noted that this connection becomes particularly critical when a person is already battling a physical illness. A person with a chronic condition suffering from depression may face difficulties adhering to treatment regimens, proper nutrition, physical exercise, or participating in rehabilitation.
Critzas also pointed out that mental state affects patients' ability to maintain social connections during recovery. She added that care and isolation can reduce support and contribute to stress.
Consequently, healthcare professionals need to look beyond just one physical diagnosis. For instance, an endocrinologist might focus solely on hormonal and hormone replacement therapy but fail to account for the fact that anxiety, poor sleep, or depression also require attention.
Critzas insisted on the necessity of an interdisciplinary approach, combining medical and mental health specialists to gain a complete picture of the patient's condition. HQA's findings point to a similar issue in the treatment process.
Tracking Outcomes
The organization noted that gaps in follow-up records after mental health hospitalization call into question what happens to patients when transitioning from inpatient to community-based care. Although the data does not explain the causes of these gaps, it highlights the continuity of care as an area for further investigation.
Luis Bota, CEO of HQA, stated that monitoring health indicators over time is important because access to healthcare itself does not guarantee that patients receive adequate care or achieve better outcomes.
Bota stressed: 'Measurement allows us to determine where the healthcare system is succeeding and, importantly, where there are opportunities for improvement.'
The HQA report covered over 200 healthcare quality indicators and data from 7.38 million medical plan beneficiaries, representing over 84% of the insured population in South Africa.
In conclusion, Critzas reiterated that the relationship between mental and physical health must be considered in long-term patient support. She identified three areas of interaction: biology, behavior, and belonging. Mental health can influence biological processes such as sleep and inflammation, behavior, such as adherence to treatment, and social connections during recovery.