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Improving the physical health of people with mental health problems

This evidence-based information was developed to improve the physical health and wellbeing of people living with mental health problems.

There is overwhelming evidence from the Marmot Review on health inequalities that addressing lifestyle factors alone will not increase the life expectancy of people with mental health problems.

This document focuses on how to deal with some of the main risk factors for physical health problems, and helps to make sure that people living with mental health problems have the same access to health checks and healthcare as the rest of the population.

The following key areas for action to improve health outcomes were identified - each of these areas is associated with particular risk factors that can have a detrimental effect on physical health and reduce life expectancy:

  • Support to quit smoking
  • Tackling obesity
  • Improving physical activity levels
  • Reducing alcohol and substance use
  • Sexual and reproductive health
  • Medicine optimisation
  • Dental and oral health
  • Reducing falls

Key facts

  • Mortality among mental health service users aged 19 and over in England was 3.6 times the rate of the general population in 2010/11. 
  • People in contact with specialist mental health services per 100,000 service users, compared with 100,000 in the general population, had a higher death rate for most causes of death, in particular:

-          Nearly four times the rate of deaths from diseases of the respiratory system at 142.2, compared with the general population at 37.3

-          Just over four times the rate of deaths from diseases of the digestive system at 126.1, compared with the general population at 28.5

-          Nearly three times the rate of deaths from diseases of the circulatory system at 254, compared with the general population at 101.1.

  • Within these disease areas specific conditions that accounted for a high proportion of deaths among service users (under the age of 75) were:

-          Diseases of the liver at 7.6% of deaths (1,430 in total)

-          Ischaemic heart diseases at 9.9% of all deaths (1,880 in total).

  • The relative difference in mortality rates was largest among people aged 30 to 39: almost five times that of the general population.
  • People with severe and enduring mental health problems have the lowest employment rate of all groups of people with a disability at just 7%.
  • There were 198 deaths of people detained under the Mental Health Act in 2013/14, the majority of which were due to natural causes, including preventable physical ill health