Summarised in an Academy of Royal Colleges publication⁶⁶ types of physical health problems associated with mental ill health include:

• Major depression doubles the lifetime risk of developing Type 2 diabetes
• Standardised mortality rates for older people with depression is two to three times higher if untreated or unresolved
• People with schizophrenia are three to four times more likely to develop bowel cancer
• People with schizophrenia have a 52 per cent increased risk of developing breast cancer.

Co-morbid health anxieties or mental health disorders are associated with:

• Poorer objective health outcomes
• Poorer subjective health outcomes
• Higher use of healthcare resources
• Wider costs of, for example, lack of employment, sickness absence, informal family care and support.

Many individuals do not have physical and psychological needs met through:

• The continued stigma of mental health problems
• Physical explanations may be more acceptable and understandable
• A continued lack of expertise and training in psychological assessment, management and mindedness for many practitioners
• Inadequate service design and provision
• Lack of integrated ‘whole person’ commissioning structures and provider organisations

NICE clinical guidelines for schizophrenia and bipolar disorders ^67-68 include recommendations for physical healthcare, and within regular case reviews, community mental health services are expected to ensure access to regular physical health checks and healthcare.