Improving the physical health of people with severe mental illness

Abstract

People with severe mental illness are three times more likely to die prematurely than the general population. Three-quarters of deaths arise from physical illnesses, the biggest cause being cardiovascular disease (CVD), far commoner than suicide. Psychotic illness, adverse treatment effects, lifestyle and socio-economic disadvantage combine to markedly increase risks for CVD and diabetes, often ignored by inadequate or discriminatory healthcare. We argue for more proactive approaches to address cardiometabolic risks. CVD risk has been reduced in the general population over the last 30 years, but not for those with severe mental illness. Reducing this health inequality should be core business for primary care and is overdue. This article will focus on physical conditions arising as a consequence of experiencing severe mental illness, rather than those that may be a primary organic cause of psychosis.