Reducing excess mortality in severe mental illness - a narrative review

Area of Science:

• Public Health
• Psychiatry
• Internal Medicine

Background:

• Individuals with severe mental illness experience a significantly reduced life expectancy, often 10-20 years shorter than the general population.
• This mortality gap is largely attributed to preventable physical health conditions, including cardiovascular, respiratory, infectious diseases, and cancer.
• Current healthcare systems often provide fragmented care, leading to under-screening and undertreatment of these physical conditions in psychiatric settings.

Purpose of the Study:

• To highlight the disparity in life expectancy between individuals with severe mental illness and the general population.
• To identify the key physical health conditions contributing to premature mortality in this demographic.
• To propose integrated care strategies within psychiatric services to address the mortality gap.

Main Methods:

• Review of existing literature on mortality rates and causes of death in severe mental illness populations.
• Analysis of barriers to physical healthcare access and treatment within mental health services.
• Synthesis of evidence supporting integrated care models, including physical screening, proactive treatment, and lifestyle interventions.

Main Results:

• Severe mental illness is associated with a substantial reduction in lifespan due to physical diseases.
• Fragmented care and lack of integrated physical health services exacerbate this disparity.
• Targeted interventions such as physical screening, smoking cessation, and cancer checks are crucial.

Conclusions:

• Integrating comprehensive physical health screening and management into psychiatric services is essential.
• A multidisciplinary, person-centred approach to care can effectively address the physical health needs of individuals with severe mental illness.
• Implementing these integrated strategies has the potential to significantly reduce the mortality divide and improve overall health outcomes.