Based on UK data to 2018, there has been an upward trend over three decades in falling life expectancy in people with severe mental illness (SMI), other mental disorders and drug related deaths (DRDs). We will begin the session with a brief outline that demonstrates that, even compared to falling life expectancy in people in the poorest parts of the UK, our patients are dying earlier and of preventable causes. We might also speculate about how COVID-19 widened inequalities even more, but the session's focus will be on solutions.
Health services (primary care, acute care and secondary mental health care) are only part of the solution here, but what we are doing already is not working. We will set out a multisystem public health approach to reverse rising mortality. Each speaker will provide a different perspective on what needs to change to prevent, detect early and ensure holistic treatment of the poor physical health of our patients. We aim to focus on what busy clinicians and community activists can do in practical terms to raise and reverse these issues.
This session aims to:
- Use published data to demonstrate the differences between people with severe mental illness (SMI) and the rest of the population. Show how these differences have increased over three decades from standardised mortality ratio (SMR) of 1.6 in the 1990s, to SMR 2.5 by 2007, now SMR 4.5 measured in England SMI to 2018 (Ref 1) This means that someone with SMI is 4 ½ times more likely to die before the age of 75 than his/her neighbour.
- Show how the drivers of poorer physical health are common to all mental disorders (SMI, common mental disorders, dementia etc), intellectual disability, alcohol/substance misuse, personality disorder and neurodiversity (Refs 1-2) – with the single exception of anorexia nervosa (the mental disorder with the highest premature mortality, with 25 years of life lost).
- Set out paradigms of prevention and intervention that address the key causes of noncommunicable disease – that break with the traditional disease and organ specific approaches. Given our failures as a society to reverse rising premature mortality, we will present coproduced models that work across multiple, fragmented health services and other systems.
- Drug related deaths in the UK, among the highest in Europe, will be presented to highlight Carol Black's two reports and other evidenced solutions (Ref 3)
Chair: Peter Byrne, East London Foundation NHS Trust, United Kingdom
Joseph Firth, University of Manchester, United Kingdom
Hannah Moore, Equally Well, Southend on Sea, United Kingdom
Maggie Rae, Faculty of Public Heath, London, United Kingdom
