The Rethink Mental Illness story

Current state of play

One in four people will experience a mental illness in their lifetime – it is not as uncommon as you think. Mental illness includes depression, schizophrenia, bipolar disorder, anxiety disorders, personality disorders, plus others.

Approximately 1% of the population in England currently live with a severe mental illness. Prevalence is slightly higher in males than females, and those living in areas of deprivation are more likely to be living with a mental illness¹.

What’s even more shocking is that people living with a severe mental illness are at a greater risk of poor physical health and have a higher premature mortality than the general population². People with SMI in England:

• die on average 15 to 20 years earlier than the general population³
• are 4.5 times more likely to die prematurely than the general population⁴

This disparity is known as the mortality gap.

It is important to note that people severely affected by mental illness do not die earlier than the general population simply because of their mental illness; it is due to the secondary physical illnesses they develop, such as hypertension, cardiovascular disease, cancer, and type 2 diabetes. Side effects of medication (lethargy, weight gain, reduced motivation), smoking, and poor diet also play a role in the mortality gap.

Research shows that people severely affected by mental illness spend more of their time being inactive during the day in comparison to the general population⁵. In order to reduce the chance of people severely affected by mental illness developing secondary long-term conditions and reduce the mortality gap, they need to be supported and encouraged to be more active.  Which is why what we do is so important.

So what can we do to address the mortality gap?

Everyone diagnosed with a mental illness is entitled to an annual physical health check with their GP. The health check covers:

• Blood cholesterol levels
• Blood glucose levels
• Blood pressure
• Smoking
• Alcohol consumption
• Height and weight

Physical activity is proven to support weight management, reduce blood pressure, blood glucose and cholesterol levels so is a great way to improve physical health markers. For people living with a severe mental illness, physical activity can hugely benefit their symptoms including;

• Improve mood and reduce symptoms of depression
• Reduce anxiety
• Improve sleep
• Reduce the effects of some anti-psychotic medication

The importance of getting active

In a recent study, we found that physical activity improves resilience, mental wellbeing, quality of life and overall health for people living with severe mental illness. You can read the full report on our website.

Everyone who supports someone’s mental health has a duty of care to support their physical health too. But resources are stretched, funding is limited, and clinical mental health experts don’t have the expertise to provide consistent physical health and activity advice. What we need to do is create seamless links between mental and physical health care and support and utilise existing community infrastructure.

We are now embarking on a new intervention in partnership with people severely affected by mental illness to embed physical activity into the community mental health pathway and support people’s physical health and increase physical activity levels, linked with our Building Communities that Care programme.

We are also working in partnership with 15 other leading health and social care charities to support people living with long-term conditions to be active in a way that works for them through a campaign, backed by Sport England, called We Are Undefeatable. The campaign includes a range of tools and resources to support people to move more to support their condition.

Physical activity has the power to improve people’s lives, mentally, physically, socially and emotionally. If we support people in the right way, the opportunities are endless.

For more information about our work at Rethink Mental Illness, please visit https://www.rethink.org/ or contact Mel, Physical Activity Programme Manager at mel.islin@rethink.org.

References

1.Quality and Outcomes Framework (QOF): Severe Mental Illness, NHS Digital 2021
2. DE Hert M and others. ‘Physical illness in patients with severe mental disorders’ World Psychiatry 2011: volume 10, issue 1, pages 52 to 77 (viewed on 2 July 2018) ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7
3. Chesney E and others. ‘Risks of all-cause and suicide mortality in mental disorders: a meta-review’ World Psychiatry 2014: volume 13, issue 2, pages 153 to 160 (viewed on 2 July 2018) ↩
4. NHS Digital. ‘NHS Outcomes Framework Indicators: Excess under 75 mortality rate in adults with serious mental illness’ 2016 (viewed on 2 July 2018) ↩ ↩2 ↩3
5. Vancampfort et al (2017) Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta‐analysis