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:
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 |