Increasing uptake of physical health checks for people living with severe mental illness: a systematic review

Elizabeth Emsley; Sarah A Sullivan; Elizabeth Rose-Innes; Emma Sidebotham; Clare E French

doi:10.3399/BJGP.2024.0826

Published eLetters

eLetter submission guidelines

Submit a Response to This Article

Compose eLetter

Title *

Author Information

Contributors

First Name and Middle Initial *

First or given name, e.g. 'Peter'.

Last Name *

Your last, or family, name, e.g. 'MacMoody'.

Email Address *

Your email address, e.g. higgs-boson{at}gmail.com. PLEASE NOTE: your email address will be published.

Occupation *

Your role and/or occupation, e.g. 'Orthopedic Surgeon'.

Affiliation *

Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Jump to comment:

Reducing physical health inequities in people with severe mental illness
Ella K.M. Reynolds

Published on: 10 March 2026

Published on: (10 March 2026)
Page navigation anchor for Reducing physical health inequities in people with severe mental illness
Reducing physical health inequities in people with severe mental illness
Ella K.M. Reynolds, Programme Coordinator & Lead for Nursing Professions, University Centre South Devon, Paignton, UK
Co-authors:

Susan Speak; Lead Nurse for Physical Healthcare, Devon Partnership Trust, Exeter, UK
Mary Emmens; Learning & Development Manager, Devon Partnership Trust, Exeter, UK
Colm Owens; Consultant Psychiatrist & Chief Medical Officer; Cornwall Partnership NHS Foundation Trust
Rory Honney; GP, Public Health Consultant & Deputy Medical Director for Planned Care; Corner Place Surgery, Paignton, UK / Torbay & South Devon NHS Foundation Trust, Torbay Hospital, Torquay, UK
Samuel P Trethewey; Public Health Registrar & GW4-CAT PhD Programme Fellow; Children & Young People's Mental Health Research Collaboration (ChYMe), University of Exeter, Exeter, UK

We applaud Emsley and colleagues for drawing attention to an important and, as demonstrated by their review, under-researched issue.¹ The preventable physical health morbidity and premature mortality endured by people with severe mental illness (SMI) necessitates systemwide action to reduce health inequities.

The main drivers of physical morbidity and mortality in people with SMI include cardiovascular disease and cancer, largely due to modifiable risk factors.^2,3 Physical health checks are therefore an important mechanism by which healthcare providers can identify those at greatest risk of adverse physical health outcomes and, consequently, offer tailored support to reduce these risks.^...
Show More

Co-authors:

Susan Speak; Lead Nurse for Physical Healthcare, Devon Partnership Trust, Exeter, UK
Mary Emmens; Learning & Development Manager, Devon Partnership Trust, Exeter, UK
Colm Owens; Consultant Psychiatrist & Chief Medical Officer; Cornwall Partnership NHS Foundation Trust
Rory Honney; GP, Public Health Consultant & Deputy Medical Director for Planned Care; Corner Place Surgery, Paignton, UK / Torbay & South Devon NHS Foundation Trust, Torbay Hospital, Torquay, UK
Samuel P Trethewey; Public Health Registrar & GW4-CAT PhD Programme Fellow; Children & Young People's Mental Health Research Collaboration (ChYMe), University of Exeter, Exeter, UK

We applaud Emsley and colleagues for drawing attention to an important and, as demonstrated by their review, under-researched issue.¹ The preventable physical health morbidity and premature mortality endured by people with severe mental illness (SMI) necessitates systemwide action to reduce health inequities.

The main drivers of physical morbidity and mortality in people with SMI include cardiovascular disease and cancer, largely due to modifiable risk factors.^2,3 Physical health checks are therefore an important mechanism by which healthcare providers can identify those at greatest risk of adverse physical health outcomes and, consequently, offer tailored support to reduce these risks.⁴

In Devon, priority areas to improve physical health in patients with SMI include strengthening partnership working between physical and mental health services, improving data sharing to identify patients not accessing screening services, tailoring support to increase accessibility and acceptability, and increasing physical health expertise in our mental health workforce.

As part of this, two complementary ‘Physical Health Skills’ short courses were developed for Devon Partnership Trust, aimed at all staff in Bands 3-8 working in mental health and learning disability settings. Both the ‘Fundamental’ and ‘Advanced’ courses focus on improving physical health knowledge and skills in the context of mental health care. Evaluation of the courses are ongoing, but initial participant feedback suggests a positive impact on staff knowledge and attitudes and increased confidence in physical health risk assessment and management across a range of mental health settings (community and inpatient).

Mental health professionals are uniquely positioned to support physical health, as they are “a crucial, and often the only, point of contact with the health care system” for many with SMI.⁵ Trusted mental and physical health professionals must work in partnership to provide more holistic, person-centred care, to better support mental and physical health simultaneously.⁶ This includes collaboration with primary care professionals, to support patients to access physical health checks.

Strengthening physical health skills in mental health staff may help to improve both staff and patient awareness of the importance of screening and physical health checks, increase uptake and, ultimately, reduce health inequities in people with SMI.

References

1. Emsley E, Sullivan SA, Rose-Innes E, Sidebotham E, French CE. Increasing uptake of physical health checks for people living with severe mental illness: a systematic review. Br J Gen Pract 2026; 76(762): e910–e917. DOI: 10.3399/BJGP.2024.0826
2. Peckham E, Lorimer B, Spanakis P, et al. Health-risk behaviours among people with severe mental ill health: understanding modifiable risk in the Closing the Gap Health Study. Br J Psychiatry. 2023; 222(4):160-166. DOI:10.1192/bjp.2022.143
3. Campion J, Johnston G, Shiers D, Chew-Graham C. Why should we prioritise smoking cessation for people with mental health conditions? Br J Gen Pract 2023;73(731):251-253. DOI: 10.3399/bjgp23X732921.
4. NHS England. Improving the physical health of people living with severe mental illness: guidance for integrated care systems. 2024. Available at: www.england.nhs.uk/long-read/improving-the-physical-health-of-people-living-with-severe-mental-illness.
5. Rogova A, Lowenstein LM, Reitzel LR et al. (2025). Missed Opportunities for Lung Cancer Screening Among Patients With Behavioral Health Disorders With Elevated Cigarette Smoking Rates: Lung Cancer Screening and Behavioral Health. Chest 2025; 168(1):269–275. DOI: 10.1016/j.chest.2024.11.039
6. Public Health England. NHS population screening: improving access for people with severe mental illness. 2021. Available at: www.gov.uk/government/publications/population-screening-access-for-people-with-severe-mental-illness/nhs-population-screening-improving-access-for-people-with-severe-mental-illness.
Show Less

Competing Interests: EKM Reynolds is commissioned by Devon Partnership Trust to develop and deliver the physical health skills courses for mental health staff, on behalf of University College South Devon. SP Trethewey is supported by the Wellcome Trust funded GW4 Clinical Academic Training (GW4-CAT) PhD Programme for Health Professionals (Award ref: 341567/Z/25/Z). C Owens is a member of the NHS England mental health supply side review group. The authors declare no other competing interests. The views expressed in this article are those of the author(s) and not necessarily those of their employers or affiliated organisations.

Main menu

User menu

Search

Increasing uptake of physical health checks for people living with severe mental illness: a systematic review

Published eLetters

Plain text

Vertical Tabs

Jump to comment:

Co-authors:

Co-authors:

In this issue

Citation Manager Formats

Keywords

More in this TOC Section

Related Articles

Cited By...

NAVIGATE

RCGP

MY ACCOUNT

NEWS AND UPDATES

AUTHORS & REVIEWERS

CUSTOMER SERVICES

CONTRIBUTE

CONTACT US

Main menu

User menu

Search

Increasing uptake of physical health checks for people living with severe mental illness: a systematic review

Published eLetters

Plain text

Vertical Tabs

Jump to comment:

Co-authors:

Co-authors:

In this issue

Citation Manager Formats

Jump to section

Keywords

More in this TOC Section

Related Articles

Cited By...

NAVIGATE

RCGP

MY ACCOUNT

NEWS AND UPDATES

AUTHORS & REVIEWERS

CUSTOMER SERVICES

CONTRIBUTE

CONTACT US