Kaleidoscope

In this work the overall mortality pooled relative risk was 2.2: a median 10 years of potential life was lost, with approximately 8 million deaths per annum attributable to mental ill-health. The mortality risk for psychoses was significantly higher than for major affective, bipolar affective, and anxiety disorders, and in-patient samples had worse outcomes than community samples; no differences were determined for sample source, diagnostic system utilised, or global geographical location. 17.5% of deaths were due to ‘unnatural’ causes, including suicide; this is striking and it also reinforces the comorbid physical health needs of those with mental health problems, with 67.3% of the additional deaths being due to ‘natural’ causes such as cardiovascular disease. An editorial in JAMA Psychiatry 3 draws an interesting parallel with the US Air Force, which determined in the 1990s that suicide was an institutional problem and introduced a programme that included awareness and prevention training, champions to identify and funnel at-risk individuals, and induction and follow-up mental-health screening questionnaires: suicide rates fell from 16.4 to 9.4/100 000 within 4 years. [...]a quarter of a century after the birth of its last iteration, the 11th edition of the International Classification of Diseases (ICD) is just around the corner – due 2017.