People with mental health conditions face a significantly higher risk of physical injuries, according to a new University of Michigan study.
These include unintentional injuries, such as falls and traffic accidents, and also injuries from self-harm and assault.
The newly published findings, which received U.S. federal funding, indicate an urgent need to integrate injury prevention into mental health care.
While previous research has established that individuals with mental health conditions are at greater risk for chronic physical diseases as they age, less attention has been paid to their vulnerability to physical injuries. Existing studies have largely focused on intentional injuries, including self-harm and suicide attempts, and in some cases assault victimization.
Until now, the role of mental health in unintentional injuries-the most common type of injury in the population-has remained poorly understood, said study lead author Leah Richmond-Rakerd, assistant professor of psychology.
Injuries are an important public health concern, she noted. They are a leading cause of premature mortality in the United States and worldwide, and are a major source of pain, disability and lost productivity. Unintentional injuries account for the majority of injuries, yet they have rarely been examined as a potential consequence of poor mental health.
To address this gap, researchers analyzed population-wide administrative data from nearly 5 million individuals in Norway and New Zealand. Mental health conditions were identified through primary care records and inpatient hospital records. Injuries were identified through primary care records, inpatient hospital records and injury insurance claims. Participants were followed over periods ranging from 14 to 30 years.
Individuals with mental health conditions had an elevated risk of subsequent self-harm injuries and injuries resulting from assault, the study indicated. However, they also had a significantly increased risk of unintentional injuries. These associations were observed across a range of mental health conditions and injury types, with particularly strong links to injuries affecting the brain and head. Importantly, the increased risks could not be explained by preexisting injuries or by socioeconomic background.
"These findings indicate that individuals with mental health conditions are vulnerable to a broad range of injuries," the researchers said. "People with mental health conditions are an important and underrecognized population for injury prevention efforts."
The study reinforces the importance of continued assessment and prevention of self-harm among individuals with mental health conditions, as well as the use of evidence-based strategies to reduce their risk of victimization. At the same time, it points to new directions for health care and policy.
Researchers call for more integrated health care services, such as embedding psychoeducation about injury risk into mental health treatment and identifying opportunities to intervene during acute-care encounters, including mental health-related hospital admissions. The findings also underscore the need for enhanced public health surveillance to better track and prevent injuries among people with mental health conditions.
The research highlights a critical but overlooked intersection between mental health and physical safety-one that could inform more holistic approaches to care and ultimately save lives, the researchers say.
Co-authors include Barry Milne and Stephanie D'Souza (University of Auckland); Renate Houts, Terrie Moffitt and Avshalom Caspi (Duke University); Lara Khalifeh (University of Michigan); Gabrielle Davie (University of Otago); Sidra Goldman-Mellor (University of California, Merced); and Fartein Ask Torvik (University of Oslo and Norwegian Institute of Public Health).
The findings appear in Nature Mental Health.
The funding sources for this project included the U.S. National Institute on Aging (R01AG069939, R01AG032282, P30-AG034424), U.S. National Institute of Child Health and Human Development (P2C-HD065563), UK Medical Research Council (MR/X021149/1), and the Research Council of Norway.
