Physical healthcare outcomes for people with severe mental illness

People with severe mental illness die much younger than people in the general population and this is not explained by high suicide rates in this population. While lifestyle factors such as poor diet and limited physical activity, alcohol and cigarette consumption are contributory, it is accepted that clinical recognition and early intervention are sub-optimal. Better evidence is required to understand contact with hospital services. The study aims to provide evidence about the medical outcomes of people with severe mental illness (SMI). 

Key questions 

In Phase 1 of this study the primary research question is: do people with SMI have worse medical outcomes across a range of life-limiting conditions when compared to people without SMI? More specifically, the research seeks to understand what might account for these outcomes. Are people with SMI (compared to those without): (a) diagnosed later? (b) do they get the same kind of hospital treatment and care? (c) do they die younger? and (d) what other factors might assist in improving outcomes? 

While the sample for Phase 1 equates to a full population, the analysis lacks considerable explanatory contextual and confounding variables. Phase 2 of the study, using 28% Census sample (the Northern Ireland Longitudinal Study), will provide mortality rates of people diagnosed with serious life-limiting conditions (Cancers, T2 diabetes and CHD), using prescription data as indicators for exposure (i.e. SMI – all medications for psychotic and bi-polar disorders), comparing people with SMI and people without SMI, and controlling for the usual potential confounders. The census data will provide a wide range of potential predictors of the outcomes. 

Project lead 

Professor Gerard Leavey, Ulster University (ADR Northern Ireland).

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