Wellness: A social justice issue for persons with behavioral health disorders

Persons with behavioral health disorders face disabling health conditions at a significantly greater rate than the general population and are dying an average of 25 years earlier (NASMHPD, 2006).These dramatic rates of morbidity and mortality are commonly due to modifiable risk behaviors including poor nutrition, lack of exercise, and tobacco-use. Approximately 29% of men and 60% of women with serious mental illness are obese (compared to 17.7% and 28.5% respectively in the general population) (3rd National Health and Nutrition Examination survey). Tobacco use among this population ranges from 40-90%, (e.g., Grant, et al., 2004), over twice that of the general population. The causes of greater obesity and tobacco use among persons with behavioral health conditions are complex, but clearly associated with the social inequalities. These individuals receive inadequate healthcare and are not afforded the same opportunities for wellness as the general population (Murali & Oyebode, 2004). Persons with behavioral health disorders are motivated to quit smoking and lose weight, and report a strong desire to lead healthy lives, but are often not provided the appropriate level of care to help them achieve desired behavioral change (Allison et al., 2009). In this presentation, we discuss the concept of wellness as a social justice issue for persons with behavioral health disorders. Focusing on tobacco use and obesity, we will present a summary of bio-psycho-social factors that lead to heightened risk among these persons, present the evidence for intervening, and offer pragmatic strategies for integrating wellness initiatives into public behavioral health services.