What is the problem?

  • The life expectancy for a male with psychosis (schizophrenia) is 15–20 years less than average with more than 60 per cent of premature deaths not directly related to suicide.62
  • There are many reasons for this high death rate but failure to prevent, diagnose and treat are included and could be remedied.
  • Fifty per cent of people with mental health problems have a co morbid physical illness.
  • In a study of young people (85 young people aged 16 to 27 years) treated for first episode psychosis, a third had metabolic syndrome or showed metabolic abnormalities.63

Smoking is the main cause of preventable death in the general population.

  • People with a mental disorder smoke much more than people without a mental disorder: they consume 42% of all tobacco consumed in England.
  • 59% of people with a first episode of psychosis smoke – a rate 6x higher than non psychotic peers.64
  • Increased smoking is responsible for most of the excess mortality of people with severe mental health problems. 62

Obesity is of similar concern:

  • It is likely to be the prime cause of higher rates of type-2 diabetes
  • It is also socially excluding, greatly distresses services users especially in the early phase of rapid weight gain and contributes to treatment discontinuation.

Having a mental health problem increases the risk of physical ill health:

  • Co-morbid depression doubles the risk of coronary heart disease in adults and increases the risk of mortality by 50 per cent.

Medication side effects are:

  • Common, e.g. metabolic syndrome and extrapyramidal side effects
  • Potentially severe, e.g. neuroleptic malignant syndrome, lithium toxicity and cardiomyopathies.
  • Cardiovascular risk increases after first exposure to any antipsychotic drug, 65

In people with severe mental health problems, there is increased occurrence of:

  • Diabetes (prevalence of, at least, 15 per cent in people with schizophrenia, 5 per cent in the general population). This may also be culturally influenced.
  • Cardiovascular disease
  • Hyperlipidaemia
  • Chronic obstructive pulmonary disease (COPD)
  • Bowel cancer
  • Venous thrombosis and pulmonary embolism