Why do people with severe mental illness have poor cardiovascular health?—The need for implementing a recovery-based self-management approach

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Abstract

People with severe mental illness (SMI) die significantly earlier than their well counterparts, mainly due to preventable chronic conditions such as cardiovascular disease (CVD). Based on the existing research, this perspective paper summarises the key contributors to CVD in people with SMI to better target the areas that require more attention to reduce, and ultimately resolve this health inequity. We discuss five broad factors that, according to current international evidence, are believed to be implicated in the development and maintenance of CVD in people with SMI: (1) bio-psychological and lifestyle-related factors; (2) socio-environmental factors; (3) health systemrelated factors; (4) service culture and practice-related factors; and (5) research-related gaps on how to improve the cardiovascular health of those with SMI. This perspective paper identifies that CVD in people with SMI is a multi-faceted problem involving a range of risk factors. Furthermore, existing chronic care or clinical recovery models alone are insufficient to address this complex problem, and none of these models have identified the significant roles that family caregivers play in improving a person’s self-management behaviours. A new framework is proposed to resolve this complex health issue that warrants a collaborative approach within and between different health and social care sectors.

Original languageEnglish
Article number12556
Number of pages12
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number23
DOIs
Publication statusPublished - 29 Nov 2021

Keywords

  • Cardiovascular disease
  • Caregiver
  • Chronic condition selfmanagement
  • Comorbidity
  • Integrated care
  • Recovery
  • Self-care
  • Severe mental illness

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