Overview
Severe mental illness (SMI) is defined as diagnosable mental, behavioural, or emotional disorders that cause serious functional impairment that substantially interferes with, or limits, one or more major life activities.
People living with severe mental illness have a life expectancy 15-20 years younger than the general population, and this is largely accounted for by physical health conditions, including cardiovascular disease.
We know that people with severe mental illness are more likely to be exposed to many of the risk factors associated with cardiovascular disease, including smoking, obesity, and deprivation. We also know that they are more likely to encounter barriers when seeking help, experience fragmented care, and face stigma when their physical health concerns are raised. The result is a health gap that has persisted for decades despite repeated warnings and growing evidence.
The Left Behind Report sets out some practical policy solutions to improve cardiovascular disease outcomes for people living with severe mental illness.
Key policy recommendations
- The UK Government should set a 10-year target to reduce smoking prevalence amongst people with severe mental illness in England.
- The UK Government must implement a comprehensive approach to increasing the accessibility, affordability and appeal of healthier food and drink products.
- Commissioners should ensure consistent and accessible provision of effective weight management support for people with severe mental illness.
- The Department of Health and Social Care and the NHS in England must incentivise healthcare systems to improve the monitoring, quality of delivery, and follow-up of the Annual Health Check for people with severe mental illness.
- Integrated Care Services should be supported to commission liaison psychiatrists to provide input into specialist cardiology services to improve the physical health management of people with severe mental illness in secondary care settings.
- All NHS psychiatric and primary care services in England should be adequately trained and supported to adopt the Lester Tool as a minimum standard to monitor and improve the physical health outcomes of people living with severe mental illness.
Read report for full recommendations
About our policy series
This is the first report in a series led by BHF’s Policy & Public Affairs team, highlighting the inequalities in cardiovascular disease prevalence, care and outcomes experienced by Inclusion Health groups.
Inclusion Health (IH) is an umbrella term used to describe people who are socially excluded, who typically experience multiple intersecting risk factors for poor health, such as stigma, discrimination, and deprivation. This includes people experiencing homelessness, Gypsy, Roma and Traveller communities, and people in contact with the justice system.
Available data is beginning to show these groups face some of the starkest cardiovascular inequalities in the UK. This series of policy reports aims to highlight IH as a priority for national policymakers and healthcare leaders in addressing wider health inequalities.
