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Improving physical health in people with severe mental illness

02 November 2020
Volume 31 · Issue 11


People with severe mental illness have a higher mortality than the general population. Sheila Hardy explains how nurses can address the health disparities that people with severe mental illness face

People with severe mental illness have a higher mortality than the general population, with the main cause of early death being from a physical condition. Practice nurses are well placed to address the health disparities that people with severe mental illness face. This article describes the reasonable adjustments that can be made to increase engagement with patients.

Severe mental illness (SMI) includes schizophrenia, bipolar disorder and other psychoses. A study carried out in the UK (Hayes et al, 2017) found a mortality gap between people with SMI and the general population of up to 25 years. Evidence suggests that 75% of this excess mortality is caused by physical illness such as respiratory disease, diabetes and cardiovascular disease (Liu et al, 2017; Barber and Thornicroft, 2018). Factors which may have an impact on premature mortality in this group include economic disadvantage, unhelpful health behaviours (smoking, poor diet, lack of exercise), and difficulties accessing and adhering to medical treatments (Olfson et al, 2015). The antipsychotic medication sometimes used to treat SMI is also linked with premature mortality as it contributes to the development of cardiovascular disease, diabetes and obesity (Mitchell et al, 2013; Torniainen et al, 2015). People with SMI are often not given adequate treatment for major medical conditions which may increase their risk of premature mortality (Woodhead et al, 2016).

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