A new Public Health England (PHE) report shows
people with severe mental illness (SMI) suffer significantly worse
physical health compared to the general population, with the
greatest inequalities seen among younger people.
The report looks at GP data for
adults aged under 75. It was prompted by the inequalities that
are known to exist in people with severe mental illness who die
on average 15 to 20 years earlier than the general population. It
is part of wider work to improve the physical health of people
with mental illness, by underpinning action plans with better
data, increasing early detection and expanding access to physical
and follow-up care.
Severe mental illness refers to people who have received a
diagnosis of bipolar affective disorder or schizophrenia, or who
have experienced an episode of psychosis.
The report found patients with SMI have a higher prevalence
of:
- obesity (1.8 times more prevalent than the general
population)
- diabetes (1.9 times)
- Chronic Obstructive Pulmonary Disease (2.1 times)
- stroke (1.6 times)
- heart failure (1.5 times)
- Coronary Heart Disease (1.2 times)
- asthma (1.2 times)
Patients with SMI are also around twice as
likely to have multiple physical health conditions as the general
population.
Younger people (aged 15 to 34 years) with SMI experience the greatest
level of health inequalities. They are 5 times more likely to
have 3 or more physical health conditions than the general
population.
Younger people with SMI suffer further from a
higher prevalence of:
- obesity (3 times more prevalent than the general population)
- diabetes (3.7 times)
- hypertension (3.2 times)
Professor Julia Verne, Head of Clinical Epidemiology at Public
Health England, said:
It’s unacceptable that people with severe mental illness live
with more ill health and die up to 20 years younger than the
rest of the population.
We need to look beyond mental illness to a ‘whole person’
approach to health care, helping to improve peoples’ lives. It
is vital that people experiencing severe mental illness are
supported to improve their physical health, including better
access to support and services such as screening programmes,
health checks and stop smoking services.
Professor Tim Kendall, national clinical director for mental
health at NHS England said:
Improving the life expectancy of people with serious mental
health issues needs coordinated action, and this report adds to
our knowledge, reinforcing the need for a continued focus on
closing the physical health outcomes gap.
The NHS is already increasing early detection and expanding
access to evidence-based physical care assessment and follow-up
care, with more than 280,000 people set to get help by 2020 to
2021, while the NHS long-term plan will set out further
priorities for the years ahead.
Mark Winstanley, CEO of mental health charity Rethink, said:
It is hugely concerning that the average life expectancy of
someone living with serious mental illness is the same as the
life expectancy of the average adult in the 1950’s.
The physical health needs of people experiencing serious mental
illness must be taken into consideration alongside their mental
health needs. We hope that this timely report from Public
Health England alongside the work of the Equally Well
collaboration will bring around much-needed change.
National Institute for Health and Care Excellence (NICE)
guideline on psychosis and schizophrenia in adults recommends GPs
monitor the physical health of patients with Severe Mental
Illness. It recommends that patients with Severe Mental Illness
have at least one annual physical health review that includes
among others, checks on weight or BMI, metabolic status, pulse and blood
pressure monitoring, as well as appropriate interventions and
support with recovery.
