Improving Physical Care For People with Mental Ill Health and Addictions

 

Lead: Charlie Lloyd (charlie.lloyd@york.ac.uk)

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

–    Hypertension

Identifying the problem:

•      There is the potential to focus on three groups:

–    Mental health problems

–    Addiction problems

–    Dually diagnosed

•      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