Improving Physical Care For People with Mental Ill Health and Addictions

Lead: Charlie Lloyd | |

Collaborators: Simon Gilbody, Tim Doran 


Health problems among people with SMI:

      Mortality gap: 13-30 year shortened life expectancy

      60% of excess mortality  due to physical illness

      There is a high prevalence of modifiable risk factors such as

    Obesity/physical inactivity

    Diabetes/poor diet

    Smoking/substance use


Identifying the problem

There is the potential to focus on three groups:

  • Mental health problems
  • Addiction problems
  • Dually diagnose

There is a considerable and growing literature on health problems among people with SMI, but very little on people with substance use disorders

Health problems among people with substance use disorders:

      There is an aging cohort of opiate users with increasingly poor health in developed countries

      The main focus of alcohol literature is on hazardous or harmful rather than dependent drinkers


General responses to the problem:

      From a health inequalities perspective, responses to health problems are poor for SMI:  Graham Thornicroft’s ‘structural discrimination’

      Stigma –a potential barrier to help-seeking

      For those that do seek help, health care is often poor

      Diagnostic overshadowing – physical problems are often wrongly attributed to SMI or addiction

 Potential future work:

      Literature reviews on substance use disorders

      Qualitative research on experiences of giving and receiving primary care in UK

      Secondary data analysis – CPRD data set

      Explore models for delivering health care to these groups

      Identify possible tools for improving quality of healthcare

      Evaluate effectiveness