| Affiliation: | 1. World Health Organization, Geneva, Switzerland;2. University of California, Berkeley, CA, USA;3. Johns Hopkins Medical Institutions, Baltimore, MD, USA;4. Fountain House, New York, NY, USA;5. Queensland Centre for Mental Health Research, Wacol, QLD, Australia;6. Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;7. Emory University, Atlanta, GA, USA;8. National Department of Health, Johannesburg, South Africa;9. National Institute of Mental Health, Tokyo, Japan;10. Heinrich‐Heine‐University Düsseldorf, Düsseldorf, Germany;11. Universit?tsklinikum Leipzig, Leipzig, Germany;12. University of Haifa, Haifa, Israel;13. Aarhus University, Aarhus, Denmark;14. Institute of Mental Health, Beijing, P.R. China;15. Department of Psychiatry, University of Naples SUN, Naples, Italy;16. National Institute of Psychiatry Ramón de la Fuente Mu?iz, Mexico City, Mexico;17. University of Copenhagen, Copenhagen, Denmark;18. Public Health Foundation of India, Haryana, India;19. Institute of Psychiatry, King's College London, London, UK;20. Schizophrenia Research Foundation, Chennai, India;21. Healthy Active Lives, Longsdon, Stoke‐on‐Trent, UK;22. Columbia University, New York, NY, USA;23. Finnish Association for Mental Health, Helsinki, Finland;24. Addis Ababa University, Addis Ababa, Ethiopia |
| Abstract: | 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. |
