Ulster University

Academic Institute

Gerry Leavey

E048

People with severe mental illness (SMI) such as schizophrenia, bi-polar disorder, and personality disorders have a reduced life expectancy (15-20 years) when compared with those in the general population, mostly due to preventable causes, multiple-morbidities, poor diet and problematic lifestyle behaviours such as smoking, alcohol and substance misuse. These problems are compounded by low self-esteem, stigma and poor physical healthcare provision. Thus, suboptimal contact with GPs, delayed screening, late detection and diagnosis may lead to treatment at advanced stages of disease in those with SMI. Therefore, there is a need to explore patterns of medical outcomes in physical healthcare for those with SMI compared to a hospital population without SMI. This may provide better evidence on disparities, opportunities for early diagnosis, and gaps in screening and treatment. Our study is intended to assist policy makers, service providers and health practitioners in addressing this major health gap. The proposed project will use the diagnostic codes provided with hospital records to examine age and sex-specific outcomes (treatment and mortality) for people with SMI who have serious life limiting diseases such as cancer, coronary heart disease and diabetes – compared to people in the general population without SMI.

The proposed research will provide a detailed understanding of physical health care in relation to people with SMI, and the efficiency of services in managing these problems. Therefore, acknowledging a call for an index of how to improve interventions and prevention of premature mortality in this cohort of individuals. The findings will improve our understanding of these factors; particularly so, in relation to the likelihood of poor detection among disadvantaged groups living in areas of high deprivation, or in rural areas. The study is intended to provide evidence on patterns of disparities between people with SMI and those without and in doing so, indicate where the systemic weaknesses may lie and where the possible remedies may be found. In the UK, 15 million people (approx.) experience life-limiting conditions, with close to 7 million experiencing multi-morbidities (Department of Health, 2014). Multi-morbidities have increased by over 200% from 2003/2004-2015/2016 (Deeny, Thorlby & Steventon, 2018). This research will inform policy makers and the public where to efficiently allocate spending towards services and pathways to care, such as better screening for the SMI population.

04/09/2019

TRE