Screening and interventions

This page offers ideas and tools to help you using screening and interventions to prevent poor physical health for people who have serious mental illness.


Undertaking early physical health screening of people living with serious mental illness (SMI) can result in the early detection and prompt treatment of medical conditions that could otherwise go undiagnosed.

Across local areas, there is a need for providers and commissioners (including NHS, local authority, communities, service user groups and voluntary sector organisations etc) to increase access to, and uptake of, evidence-based health promotion, prevention and wellbeing activities, irrespective of current care settings.

A range of interventions to promote physical health and reduce health risk behaviour can prevent subsequent physical illness as well as promote wellbeing and recovery. This can lead to significant savings through reduced later service use and other improved outcomes. Such interventions are more effective if introduced early. See Living Well for Longer (Department of Health, 2014)

The below provides information on how to minimise physical ill health in those living with SMI, through improved access and take-up of preventative interventions.

Actions to take

Carry out the recommended physical health assessments for people on the SMI register, in line with National Guidance:

  • Comprehensive cardio-metabolic risk assessment in line with the NHS health check.
  • Where indicated, relevant national screening programmes to be delivered or followed up.
  • Medicine reconciliation and monitoring.
  • General physical health enquiry.

Tools to help you

Right From The Start: Keeping Your Body In Mind RIGHT FROM THE START (RFTS) is a new resource to improve the physical health of people experiencing psychosis for the first time.

Right From The Start: Keeping Your Teeth In Mind RIGHT FROM THE START – KEEPING YOUR TEETH IN MIND is a new resource to improve the oral health of people experiencing psychosis.

Bradford Mental Health Physical Review Template.  Developed for the SystemOne, EMIS Web and Rio IT systems, it collects all the physical health data required for each service user in one place and links to relevant guidance on treatment and intervention. The template now includes all the data recommended by the Lester tool but has a few additional sections designed to meet the specific requirements of Bradford District Care Foundation Trust.

GOV.UK policy paper: Helping people live well for longer Sets out how the health and care system will become amongst the best in Europe at reducing levels of avoidable mortality.

NHS Population screening programmes: List of available NHS screening programmes.

NHS England’s Improving physical health care for people with SMI in primary care (NHS England):. National guidance for physical health screening.

NICE guidance: Psychosis and schizophrenia in adults: prevention and management (Clinical guideline 178): guideline promotes early intervention and long-term recovery, and recommends checking for coexisting health conditions.

Royal College of Psychiatrists Lester UK Adaptation (2014 update): Positive Cardiometabolic Health Resource.

Jos Trust: cervical screening and cervical abnormalities booklet

This leaflet was developed by the University of Surrey and Jo’s Cervical Cancer Trust. This is a leaflet for anyone with a cervix who finds cervical cancer screening difficult. Existing research suggests that people with severe mental illness are less likely to attend cancer screening in comparison with the general population. The leaflet supports people’s decision-making of whether to attend screening, and if they want to take up screening, to make it easier for them to attend.  

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