Physical health and multimorbidity in people with severe mental illness and impact on secondary care utilisation: risk stratification and secondary care pathway mapping

People with severe mental illness (SMI) are at an increased risk of physical health conditions, such as heart disease and diabetes. The combined burden of physical and mental health diagnoses means people with SMI are potential high-frequency users of emergency hospital care.

Linking routine GP and hospital data, this project aims to characterise the physical health of people with SMI, compared to people without SMI, and investigating multimorbidity in this population. The project also aims to explore patterns of hospital use in people with SMI.

Our research shows that people with SMI are twice as likely to experience multi morbidity, at a younger age, and often before SMI diagnosis.

People with schizophrenia were less likely to have planned hospitalisations than people without SMI. They were less likely to be diagnosed with cancer but, if they were diagnosed, were more likely to die than people without SMI.

We presented our findings to NHS fora and teams to inform the timing and content of physical health checks for people with SMI, and interventions to improve cancer screening. Some of our findings have been used: in North Yorkshire to inform modelling of future SMI and multimorbidity prevalence; and to inform Rethink Mental Illness charity’s collaborations with physical health charities.

Public Health England