Do People with Mental Health Challenges Receive Inferior Coronary Care?

New research from the University of Leicester in the UK examines the high level of mortality after a coronary event in people with mental health issues. The University, in collaboration with the Curtin Health Innovation Research Institute in Australia, collected data from 22 studies that involved over 800,000 patients with and without mental challenges. They found that those with mental health issues had a significantly higher mortality rate after a coronary event. Alex J. Mitchell, of the University of Leicester, University Hospitals of Leicester NHS Trust and Leicestershire Partnership Trust, and lead researcher, said, “Those with a diagnosis of severe mental illness were 14% less likely to receive essential coronary care procedures following their heart attack. Such procedures include coronary artery bypass graft and coronary angioplasty which have been credited with improving outcomes after heart disease in the general population. In 10 studies that specifically addressed care for people with schizophrenia, those with the disease received only half the interventions offered to those without schizophrenia.”

Miller went on to reveal that other studies found that those with psychiatric health problems had an 11% higher mortality rate in the 12 months following a coronary event than those without any history of psychiatric difficulty. Mitchell added, “People with known mental health conditions have higher background rates of cardiovascular risk factors such as smoking, inactivity, and obesity. We already know that this is reflected in a higher rate of heart disease but what we demonstrate here is that mortality is greater even after patients come under health care. We don’t yet know the reason for these poorer outcomes but it is worrying that we also find such patients may receive less frequent life-saving interventions. Patients with significant mental health problems can be considered a vulnerable group who should be receiving at least equal and possibly enhanced care.” Mitchell concluded by saying, “We urgently need to know whether patients are declining treatment or whether clinicians are not offering treatment to an equal degree.”

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Stephen Smith

    Stephen Smith

    June 4th, 2011 at 12:36 PM

    I feel that the mental health issues in those patients have overshadowed their heart problems.

    Doctors are busy folks of course. Do they see them as too much work if they have to take more time and care in explaining about their treatment options for coronary care?

    If so, that’s wrong. They should be treated on equal terms and given the same options as everyone else.

  • Audrey Phelps

    Audrey Phelps

    June 4th, 2011 at 12:56 PM

    But if the doctors offer them such treatments and they in turn refuse it, whose fault is it and where do they go from there? What can they do when the patient literally doesn’t know what’s good for them? It’s coronary care. I don’t think they have the right to
    force a certain treatment upon them, do they?

    Sounds to me like the doctors are going down the path of least resistance rather than discriminating against the mentally ill.

  • Olivia


    June 4th, 2011 at 11:45 PM

    This is one depressing fact if I’m being honest. Just why do people who already have problems suffer even more? It happens in all spheres of life and seems like even our health is no different. Maybe it’s just survival of the fittest after all.

  • margaret


    June 5th, 2011 at 3:42 AM

    are you kidding me? this is ridiculous to think that i n this day and time there is still this kind of discrimination in the ehalth care industry! shame on those providers who fail to see that everyone and their treatment should be equal in medicine!

  • blake


    June 6th, 2011 at 4:28 AM

    you also need to think about is it the lack of care or is it their lifestyle of not following up and taking the best care of their helth going to be the real blame?

  • DS


    June 6th, 2011 at 1:19 PM

    I know what you’re saying Blake and yes lemme tell you one thing if you don’t take care of your own health then no amount of care by others is gonna help.

  • p.f.a.


    June 6th, 2011 at 9:57 PM

    I’m not seeing any correlation between the two.

    If any doctor refuses to treat a patient for any reason, is it not right that he stands a very solid chance of being struck off permanently? I thought doctors couldn’t pick and choose who to treat.

  • susan robb

    susan robb

    June 7th, 2011 at 4:42 AM

    These are doctors, but they are also people who have prejudices just like the rest of us. A medical degree does not necessarily make those past beliefs about others just go away.

  • Alexander D.

    Alexander D.

    June 8th, 2011 at 11:40 PM

    @p.f.a. I’m inclined to agree. Surely no doctor would allow a patient to go untreated for any reason other than their refusal to accept it. If you’re having a heart attack, they don’t care what you have in your head. Their job is to get your heart beating again and save your life.

  • Adam V.

    Adam V.

    June 11th, 2011 at 8:53 PM

    I think it’s them declining treatment. Once a patient says “No”, the doctors are legally obligated to back off right there and then. If they even give them as much as a band-aid, they potentially set themselves up for a colossal lawsuit.

    That’s my understanding of it anyway.

  • Johnny Wiley

    Johnny Wiley

    June 11th, 2011 at 9:33 PM

    If it’s patients doing the declining,and they suffer from a condition that flares up at times, how can a physician tell when they are competent and when they are not to make a decision? Not all mental problems are obvious at once.

    That’s a rather gray area as one day they may be perfectly fine when they agree to it and the next not so good and want to change their mind when the staff come to take them down for surgery for example.

  • Leanne Stevens

    Leanne Stevens

    June 19th, 2011 at 10:04 PM

    Don’t the hospitals keep records that say when a patient refused treatment? It wouldn’t be hard to crossover the data and find out if it’s incompetent doctors or patients exercising their rights to refuse medical treatment.

    They should check before pointing the finger at doctors and claiming they discriminate against mental health patients.

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Title   Content   Author is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on