Improving Physical Care For People with Mental Ill Health and Addictions


Project 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