Stolen years – closing the mortality gap for people with severe mental ill health
There are more people in London living with a severe mental illness than in other parts of the UK. These Londoners live around 10 to 20 years less than others, and have more physical health conditions and risk factors. While these physical health conditions are mostly preventable and treatable, they are less likely to be diagnosed and treated. And when people with severe mental ill health do receive a diagnosis and treatment, their outcomes are usually worse.
The Stolen Years programme was set up to look at what can be done to reduce this.
The implementation gap
Solid evidence exists as to the reasons for this gap in life expectancy. Numerous high-quality reports provide robust recommendations about changes to make. Uptake and implementation of these recommendations has been varied due to the complexity of the causes of the gap and lack of accompanying guidance on how to make the changes. There has been no strategy to scale, extend or sustain pockets of current excellent practice.
The direct causes of premature mortality are known. Gold standard treatments exist, but unfortunately people with severe mental ill health are not accessing or benefitting from them. Evidence and service user feedback indicates three steps are required to address this:
- Increase coverage of a service or intervention
- Increase uptake by targeting approaches
- Increase benefit gained from the intervention, by tailoring approaches.
We need to make changes to the way we work to improve accessibility, acceptability and the use of healthcare for those living with serious mental illness. We need cross-sector collaboration to support innovation in services, care pathways and finance models.
There are clinical and financial arguments that support the need to change. The substantial costs and inefficiencies across health and social care associated with physical ill health for people with serious mental illness are recognised nationally – and we need to address these for Londoners.
Supporting system change
We know that if we identify and treat health problems early, people will live longer, healthier lives.
The NHS made a commitment that by April 2019 at least 60,000 Londoners living with a severe mental illness will receive a physical health assessment and be referred to appropriate treatment or support where those are needed.
In order to help the NHS achieve this goal, we developed the Stolen Years online resource, which includes tools, recommendations and information to support the work of clinicians delivering improvements in the physical health of people with severe mental illness.
You can find out more about our collaborative efforts in this blog by Dr Ofra Koffman.