S28 Premature mortality in people with mental disorders: it’s rising and here’s what we need to do

Date: Wednesday 12 July
Time: 10.30am - 11.45am
Stream: Clinical Practice

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 - 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 system

Chair: Peter Byrne, East London Foundation NHS Trust,  London, United Kingdom

Update on data on rising premature mortality in people with mental disorders and addictions

Peter Byrne, East London Foundation NHS Trust,  London, United Kingdom

Implementing physical health interventions in mental healthcare: next steps for the Lancet Psychiatry Commission

Joseph Firth, University of Manchester, Manchester, United Kingdom

Service user perspectives on smoking and healthy weight management

Hannah Moore, Equally Well, Southend on Sea, United Kingdom

Actions to reverse falling UK life expectancy and rising drug related deaths

Maggie Rae, Faculty of Public Heath,  London, United Kingdom

Please email congress@rcpsych.ac.uk or call 020 8618 4120 with any enquiries.