Ulster University

Academic Institute

Economic and Social Research Council

Yes

253

Severe Mental Illness (SMI) relates to debilitating psychiatric disorders including schizophrenia and bipolar disorder (Gov, 2018). According to the NICE Clinical guideline [CG178] approximately 1% of the population will develop psychosis and schizophrenia (NICE, 2014) and research suggests that people with SMI have increased mortality and reduced life expectancy, with deaths occurring from common physical illnesses, for example cardiovascular disease, cancers and respiratory illnesses (Lawrence & Kisely, 2010). A number of factors, such as lifestyle or unequal healthcare provision, may contribute to the increased risk of physical illness in people with SMI (Lawrence & Kisely, 2010). This study will examine SMI - defined in terms of patterns of prescriptions for antipsychotic drugs over the period 2010-2019 - in relation to (i) patterns of multimorbidity and (ii) all-cause & cause-specific mortality outcomes, over the whole of the Northern Ireland (NI) population, comparing those with and without SMI. These outcomes will be examined in relation to the range of socio-demographic and socioeconomic characteristics associated with the 2011 NI Census. Generally, the study will improve our understanding of SMI, mortality and coterminous comorbidity and/or multimorbidity. It will further clarify the nature and extent of health and social inequalities through examination of these socio-demographic and socio-economic characteristics.

Literature Evidence suggests that people with SMI have increased mortality and reduced life expectancy, with deaths occurring from common physical illnesses – e.g. cardiovascular disease, cancers and respiratory illnesses (Lawrence & Kisely, 2010). Factors such as lifestyle or unequal healthcare provision may contribute to this increased risk of physical illness in people with SMI (Lawrence & Kisely, 2010). Research is accumulating in this area - for example, results from a large meta-analysis reported that people with SMI have a significantly increased risk of cardiovascular disease and cardiovascular disease-related mortality (Correll et al, 2017). NICE guidance This area of research is of importance to Health and Social Care research due to emerging evidence showing that people with SMI die up to twenty years younger than the average population (NICE, 2018). Of note, NICE states that the major causes of death in people with SMI are preventable - cardiovascular disease, endocrine disease and respiratory failure (NICE, 2018). Proposed study We will examine SMI and mortality risk, accounting for comorbidity/multimorbidity, socio-demographic and socio-economic characteristics. This study may be of interest in relation to the management of conditions in people with SMI, and will provide detailed findings on mortality. Therefore, the proposed study will inform the evidence base and development of policy in this area.

26/06/2020

TRE