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Premature mortality of people with severe mental illness: a renewed focus for a new era

Published online by Cambridge University Press:  31 March 2022

Peter Byrne
Peter Byrne*
Affiliation:
Department of Psychological Medicine, Royal London Hospital, London, UK Public Mental Health Implementation Centre, Royal College of Psychiatrists, London, UK
*
Address for correspondence: Peter Byrne, MA, MD, MRCPsych, Royal London Hospital, London E1 1FR, UK. (Email: peter.byrne@nhs.net)
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Abstract

This perspective article applies public health principles to improve the physical health of selected populations with mental disorders. Two preventable adverse outcomes, poorer physical health and premature mortality, are described across mental disorders. Evidence of the lifetime effects of adverse childhood experiences and inequalities is presented: these are the ‘causes of the causes’. Seven drivers of physical disorders are illustrated that drive preventable deaths and as doctors, psychiatrists must lead from the front to reverse rising mortality. Evidence supports universal and selective interventions and even the most difficult challenges such as weight gain and opioid misuse are an opportunity for psychiatry to engage with individual patients and their organisations, public health colleagues, health systems and beyond. Interventions complement and do not replace existing clinical practices that reduce self-harm and prevent suicide. Mental health teams already do most of the work in this arena, and the case is made to refocus on physical health with task sharing. The top 10 recommendations within a personalised medicine framework are listed in this paper as a starting point.

Keywords

Physical healthpremature mortalitypreventionpublic healthliveropioids
Type
Perspective Piece
Information
Irish Journal of Psychological Medicine , Volume 40 , Issue 1: Themed issue on Public Mental Health , March 2023 , pp. 74 - 83
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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