Data Insight: Physical health disparities and mortality among people with severe mental illness in Northern Ireland

This Data Insight by Rachel McCarter, Michael Rosato and Gerard Leavey examines the relationship between severe mental illness (SMI), selected chronic disorders, and mortality in a population attending at hospital settings in Northern Ireland (NI) over a 12-year period.

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What we found

This study indicates:

• Being male, living in socially deprived circumstances, and living in a non-rural area are factors associated with a higher likelihood of an SMI diagnosis.

• Physical health multimorbidity – having two or more health conditions – and all-cause mortality were much higher in people with SMI.
• The most prevalent chronic conditions were chronic kidney disease (16.2 and 14.4% for males and females, respectively); malignant neoplasms (15.6 and 11.7%); diabetes mellitus (12.6 and 8.2%); and chronic obstructive pulmonary disease (9.1 and 7.3%), with the remaining circulatory diseases featuring less prominently.
• Age-standardised rates associated with no stated conditions reduce over time, whereas those associated with the accumulating conditions increase.
• Those recording SMI had a two-fold excess all-cause mortality risk when compared with those recording no SMI.

Why it matters

Perceived inequality in the value placed on mental health services compared to physical health services has become a significant policy issue in the UK. This research highlights links between these two types of health needs.

In the UK, approximately 15 million people experience physical chronic conditions, with close to 7 million experiencing multi-morbidities. Multi-morbidity has more than doubled between 2003/2004 and 2015/2016.

This research will inform policymakers on how to efficiently allocate spending towards services and pathways to care, such as better screening for SMI patients.