Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas.

Journal: World psychiatry : official journal of the World Psychiatric Association (WPA)

Volume: 16

Issue: 1

Year of Publication: 

Affiliated Institutions:  World Health Organization, Geneva, Switzerland. Johns Hopkins Medical Institutions, Baltimore, MD, USA. Fountain House, New York, NY, USA. Queensland Centre for Mental Health Research, Wacol, QLD, Australia. Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Emory University, Atlanta, GA, USA. National Department of Health, Johannesburg, South Africa. National Institute of Mental Health, Tokyo, Japan. Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. Universitätsklinikum Leipzig, Leipzig, Germany. University of Haifa, Haifa, Israel. Aarhus University, Aarhus, Denmark. Institute of Mental Health, Beijing, P.R. China. Department of Psychiatry, University of Naples SUN, Naples, Italy. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. University of Copenhagen, Copenhagen, Denmark. Public Health Foundation of India, Haryana, India. Institute of Psychiatry, King's College London, London, UK. Schizophrenia Research Foundation, Chennai, India. Healthy Active Lives, Longsdon, Stoke-on-Trent, UK. Columbia University, New York, NY, USA. Finnish Association for Mental Health, Helsinki, Finland. Addis Ababa University, Addis Ababa, Ethiopia.

Abstract summary 

Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, and strategies for implementation and scaling up of programmes with a strong evidence base are scarce. Furthermore, the majority of available interventions focus on a single or an otherwise limited number of risk factors. Here we present a multilevel model highlighting risk factors for excess mortality in persons with SMD at the individual, health system and socio-environmental levels. Informed by that model, we describe a comprehensive framework that may be useful for designing, implementing and evaluating interventions and programmes to reduce excess mortality in persons with SMD. This framework includes individual-focused, health system-focused, and community level and policy-focused interventions. Incorporating lessons learned from the multilevel model of risk and the comprehensive intervention framework, we identify priorities for clinical practice, policy and research agendas.

Authors & Co-authors:  Liu Nancy H NH Daumit Gail L GL Dua Tarun T Aquila Ralph R Charlson Fiona F Cuijpers Pim P Druss Benjamin B Dudek Kenn K Freeman Melvyn M Fujii Chiyo C Gaebel Wolfgang W Hegerl Ulrich U Levav Itzhak I Munk Laursen Thomas T Ma Hong H Maj Mario M Elena Medina-Mora Maria M Nordentoft Merete M Prabhakaran Dorairaj D Pratt Karen K Prince Martin M Rangaswamy Thara T Shiers David D Susser Ezra E Thornicroft Graham G Wahlbeck Kristian K Fekadu Wassie Abe A Whiteford Harvey H Saxena Shekhar S

Study Outcome 

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Statistics
Citations :  Wahlbeck K, Westman J, Nordentoft M et al. Outcome of Nordic mental health systems: life expectancy of patients with mental disorders in Denmark, Finland and Sweden 1987‐2006. Br J Psychiatry 2011;199:453‐8.
Authors :  29
Identifiers
Doi : 10.1002/wps.20384
SSN : 1723-8617
Study Population
Male,Female
Mesh Terms
Other Terms
Excess mortality;bipolar disorder;community level and policy-focused interventions;depression;health system-focused interventions;individual-focused interventions;physical health;risk factors;schizophrenia;severe mental disorders
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
Italy