Why Do People with Severe Mental Illness Have Poor Cardiovascular Health?-The Need for Implementing a Recovery-Based Self-Management Approach.

Sara Zabeen,Anthony Venning,Kate Fairweather,Sharon Lawn

doi:10.3390/ijerph182312556

Abstract

People with severe mental illness (SMI) die significantly earlier than their well counterparts, mainly due to preventable chronic conditions such as cardiovascular disease (CVD). Based on the existing research, this perspective paper summarises the key contributors to CVD in people with SMI to better target the areas that require more attention to reduce, and ultimately resolve this health inequity. We discuss five broad factors that, according to current international evidence, are believed to be implicated in the development and maintenance of CVD in people with SMI: (1) bio-psychological and lifestyle-related factors; (2) socio-environmental factors; (3) health system-related factors; (4) service culture and practice-related factors; and (5) research-related gaps on how to improve the cardiovascular health of those with SMI. This perspective paper identifies that CVD in people with SMI is a multi-faceted problem involving a range of risk factors. Furthermore, existing chronic care or clinical recovery models alone are insufficient to address this complex problem, and none of these models have identified the significant roles that family caregivers play in improving a person’s self-management behaviours. A new framework is proposed to resolve this complex health issue that warrants a collaborative approach within and between different health and social care sectors.

Highlights

Published: 29 November 2021In Australia and internationally, adults with severe mental illness (SMI) such as schizophrenia, schizoaffective disorder, and bipolar disorder are at increased risk of early death due to physical health problems
It is irrefutable that there remain identifiable Cardiovascular diseases (CVD) risk factors for people with SMI spanning individual, community, health system and culture, and research levels [49]
It is argued that mental health issues are a major risk factor for CVD, both directly and indirectly, impacting the recovery capacity for people with SMI [25,26,65,66]

Summary

Introduction

Published: 29 November 2021In Australia and internationally, adults with SMI such as schizophrenia, schizoaffective disorder, and bipolar disorder are at increased risk of early death due to physical health problems. Cardiovascular diseases (CVD), type 2 diabetes, nutritional and metabolic diseases, and obesity and smoking-related cancers are some of these potentially preventable chronic conditions that are frequently observed and disproportionately found among people with SMI compared with non-SMI populations [1]. This mental–physical health interface has multiple adverse impacts for the person in their daily life, and appears to generate greater difficulty in the person’s healthcare management. The economic and social burden of SMI-related CVD on the healthcare system and the community is a major cost to all key stakeholders (e.g., persons with SMI, their families, health practitioners, policy makers) [3]

Methods

Discussion

Conclusion