Equally Well is informed by an evidence review of published and unpublished literature to understand the extent of the problem, the drivers and the interventions which have been shown to be effective.
People with a mental illness and/or addiction die much earlier than their counterparts in the general population, with a two to three times greater risk of premature death (defined as dying before the age of 65). Two-thirds of this premature mortality is due to cardiovascular disease, cancer and other physical illnesses.
Rates of metabolic syndrome, viral and oral health problems, respiratory diseases, diabetes and cardiovascular disease are higher for this population group.
There’s a significant association between anti-psychotic use and risk of diabetes.
There are notable gaps in research, for example, in relation to effective interventions for Māori and Pacific populations.
Drivers of relatively poor health outcomes include:
Promising interventions include changes at a systems level and at the individual level (mainly trying to reduce exposure to known risk factors).
At a systems level, health care services need to increase integration between mental health and physical health care, and develop shared care arrangements between primary and secondary care.
Clinical guidelines need to clearly identify roles and responsibilities in relation to monitoring and managing physical health care.
Promising behaviour change interventions combine personalised support for smoking cessation, increasing physical activity, improving nutrition and general wellbeing. Interventions based on good evidence, which are service-user directed and work towards achieving long-term sustainable lifestyle changes, have been shown to be successful at an individual and small group level. However no simple or single approach has demonstrated long-term effectiveness.
Nutrition and exercise programmes that include the following characteristics are likely to have greater success.