How do we help people living with mental health conditions live longer, healthier lives?
Psychiatrist and Population Scientist Professor Simon Gilbody of the University of York, has just been awarded £1 million to build his new “Closing the gap network”. With 20 years’ experience in healthcare, Simon has seen how lives can be transformed if the same emphasis is placed on both physical and mental health. Starting this year, the special network of experts from the sciences to the arts will try to understand and tackle the root causes of why the health and life expectancy of people with severe mental ill health is so poor.
What is the ‘mortality gap’ and what are we doing to tackle it?
People who use mental health services experience the poorest physical health and most profound health inequalities of any section of the UK population.
Diabetes, heart disease and chronic respiratory illness, are two to three times more common in this group of people than for people with good mental health. Life expectancy is reduced by 20 to 25 years, and a person developing schizophrenia in their 20s can only expect, on average, to live into their 50s.
This is known as ‘the mortality gap’. Researchers have spent the past 10 years trying to understand it and intervene to reduce it.
Today our ambitious ‘Closing the Gap’ Network, supported by UK Research and Innovation, aims to address physical health inequality for people with the most severe forms of mental illness, through imaginative thinking and collaboration across research disciplines and sectors.
Closing the gap
Ten years ago, experts researching the mortality gap did so alone, investigating the problem from a narrow viewpoint within their own speciality. NHS healthcare was the same, with people being treated for their mental and physical health separately, often with physical symptoms being misdiagnosed or ignored as a feature of an underlying mental health problem.
We now understand that paying attention to both mental and physical health, as well as life circumstances, can have a huge impact on a person’s quality of life and even life expectancy.
But frustrating misconceptions still persist. Our network will work hard to dismantle them. For example, while suicide is one of the causes of premature death among people with mental health problems, it’s far from the leading cause. In reality, the big killers are heart disease, respiratory illness, diabetes and cancer – the same as the wider population, only at elevated levels. Lifestyle factors such as smoking, inactivity and poor diet are often more common and inadequately addressed. The impact of social and economic factors such as poor housing, social isolation, chronic poverty and limited access to greenspace is not as well understood as it should be.
Over the next four years, our project team, led by the University of York alongside the University of Keele, will include experts from population health, primary care, health services research, health economics, digital health, environmental science and the creative arts.
Our research will span five themes; effective interventions, technology and data, lifestyle and behaviour, social inequalities and empowerment. We’ve prioritised areas which are under-researched but have potential for new ideas. Examples include analysing ‘big data’ to understand how people move between primary, community, A&E and hospital care, how digital technologies could empower people to help manage their own health, and how interaction with the natural environment and outdoor activity could support both mental wellbeing and physical health.
Partnering with people and charities
Involving people who have experienced severe mental ill health is crucial so we are pleased to be partnering with the Mental Health Foundation. The Equality Trust will help us understand these complex issues through the lens of social, economic and political science. And the York Health and Wellbeing Cohort, 6,000 people with severe mental ill health who have expressed an ongoing interest in our research, will provide vital insights into health and lifestyle.
We hope our network will be a focus for world-leading research to reduce the mortality gap for many years to come. I’m excited to see what we can achieve together.