Food for the mind

It was a delight to read Kay-Tee Khaw's timely warning about unhealthy dietary habits ("Dying for a good fry-up", THES, February 9) as I tucked into the "full English breakfast" in our staff club at Addenbrooke's Hospital in Cambridge, her base of operations.

Her case that a healthier diet could reduce many of the physical disabilities associated with old age is watertight. Professor Khaw closes with "there is no good reason why the high rates of chronic disabling conditions now experienced in Britain cannot be reduced to the low levels we know are possible in some groups".

There is, however, a bad reason why some groups do not adopt sensible eating habits and it touches on an area rather more taboo for discussion than heart disease or stroke.

Neurotic illness is much more common in Great Britain than most people realise: the 1994 Office of Population and Census Surveys report on psychiatric morbidity found 14 per cent of the population had neurotic health problems in the week surveyed and lifetime incidence rates would be much higher.

The most common mental disorders - depression, anxiety and alcohol dependence - are all associated with maladaptive reasoning and behaviour. Eating is commonly affected.

Unless their habitual cognitive and behavioural banana skins are removed from the way, such individuals will trip even more if you scare them, for example, with a suspended sentence of physical disability to ruminate on.

The key public policy issue is that the common mental disorders have a much younger onset (usually teens or 20s) than the physical conditions listed in "Dying for a good fry-up". The proof of the pudding is the poor physical health so prominent in psychiatric services, generating more and more liaison work between mental and general health services as our patients grow older.

Our political masters have ordered specialist mental health services to concentrate on a small number of people with severe psychotic problems (in order to make underground stations and lions' dens safer places).

If we want the millions of people who are worrying themselves sick to attain a long and disability-free life, then a big community initiative to prevent or rehabilitate neurotic health problems is needed. For maximum health benefit, we probably need to reach teenagers in particular, or better still help teenagers to reach us.

For some time the Mental Health Foundation and the Health Education Authority have been developing ways to promote good mental health. It is time to follow their example, on a wider scale. Then, instead of the cri de coeur "there is no good reason why" sounder reasoning might lead . . . to routine self maintenance . . . of sounder bodies . . . which will run and run.

WOODY CANN Head of research and development Lifespan Healthcare Cambridge