Open AccessExcess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas
Author(s) -
Liu Nancy H.,
Daumit Gail L.,
Dua Tarun,
Aquila Ralph,
Charlson Fiona,
Cuijpers Pim,
Druss Benjamin,
Dudek Kenn,
Freeman Melvyn,
Fujii Chiyo,
Gaebel Wolfgang,
Hegerl Ulrich,
Levav Itzhak,
Munk Laursen Thomas,
Ma Hong,
Maj Mario,
Elena MedinaMora Maria,
Nordentoft Merete,
Prabhakaran Dorairaj,
Pratt Karen,
Prince Martin,
Rangaswamy Thara,
Shiers David,
Susser Ezra,
Thornicroft Graham,
Wahlbeck Kristian,
Fekadu Wassie Abe,
Whiteford Harvey,
Saxena Shekhar
Publication year - 2017
Publication title -
world psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 15.51
H-Index - 93
eISSN - 2051-5545
pISSN - 1723-8617
DOI - 10.1002/wps.20384
Subject(s) - psychological intervention , medicine , mental health , scope (computer science) , intervention (counseling) , public health , implementation research , health policy , psychiatry , gerontology , nursing , computer science , programming language
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.