Research Impact


Improving physical healthcare for people with severe mental illness

After finding that people with severe mental illness have a higher risk of heart disease, UCL researchers created better risk prediction tools and management strategies, now used internationally.

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28 April 2022

People with SMIs such as schizophrenia and bipolar disorder have additional physical health problems that affect their quality of life and life expectancy.

A research team from the UCL Division of Psychiatry and UCLH BRC, led by Dr Joseph Hayes and Professor David Osborn, sought to explore this issue further. They found that the risk of people under 50 with SMI dying from CVD is three times higher than people without SMI, and that the numbers continue to rise. Their team identified the risk factors responsible for why people with SMI are more prone to CVD, including higher rates of smoking, high cholesterol and obesity. 

The need for more suitable screening tools  

Their work also showed that the CVD screening tools for the general population were not suitable for people with SMI. The team went on to develop and test the world’s first CVD risk assessment tool that includes SMI diagnosis and prescriptions for antidepressants and antipsychotics.  

By revealing the scale of preventable deaths from CVD in people with SMI, Dr Hayes and Professor Osborn’s research raised awareness in doctors and policy makers about these patients’ special needs. Public Health England’s 2018 briefing on Severe Mental Illness and Physical Health Inequalities cites the research and recommends NHS and care providers target services to reduce illness and early death among people with SMI.

Informing national and international guidelines  

To ensure these services choose the right tools to support physical health in people with SMI, Professor Osborn worked with NHS experts to produce the RightCare toolkit for NHS managers. 

The team’s research has also informed national and international guidelines for doctors and pharmacists on how various medicines (statins, antipsychotics) affect physical health in people with SMI. As a result, annual cardiovascular screening has been introduced for all patients with SMI as a core element of the NHS Plan for the next decade, and more people with SMI are receiving statins to lower their cholesterol, leading to better physical and mental health outcomes.

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Research synopsis

Improving physical healthcare for people with severe mental illness

UCLH BRC research identified that people with severe mental illness (SMI) are more likely to develop heart disease than those without SMI. To close this health gap the research team developed better risk prediction tools and management strategies. These are now in use throughout the NHS and internationally to screen and monitor patients with SMI for heart (cardiovascular) disease (CVD).