Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

Nancy H Liu; Gail L Daumit; Tarun Dua; Ralph Aquila; Fiona Charlson; Pim Cuijpers; Benjamin Druss; Kenn Dudek; Melvyn Freeman; Chiyo Fujii; Wolfgang Gaebel; Ulrich Hegerl; Itzhak Levav; Thomas Munk Laursen; Hong Ma; Mario Maj; Maria Elena Medina-Mora; Merete Nordentoft; Dorairaj Prabhakaran; Karen Pratt; Martin Prince; Thara Rangaswamy; David Shiers; Ezra Susser; Graham Thornicroft; Kristian Wahlbeck; Abe Fekadu Wassie; Harvey Whiteford; Shekhar Saxena

doi:10.1002/wps.20384

Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

Nancy H Liu, Gail L Daumit, Tarun Dua, Ralph Aquila, Fiona Charlson, Pim Cuijpers, Benjamin Druss, Kenn Dudek, Melvyn Freeman, Chiyo Fujii, Wolfgang Gaebel, Ulrich Hegerl, Itzhak Levav, Thomas Munk Laursen, Hong Ma, Mario Maj, Maria Elena Medina-Mora, Merete Nordentoft, Dorairaj Prabhakaran, Karen PrattMartin Prince, Thara Rangaswamy, David Shiers, Ezra Susser, Graham Thornicroft, Kristian Wahlbeck, Abe Fekadu Wassie, Harvey Whiteford, Shekhar Saxena

Department of Clinical Medicine

212 Citations (Scopus)

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.

Original language	English
Journal	World Psychiatry
Volume	16
Issue number	1
Pages (from-to)	30-40
Number of pages	11
ISSN	1723-8617
DOIs	https://doi.org/10.1002/wps.20384
Publication status	Published - 1 Feb 2017

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Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., Druss, B., Dudek, K., Freeman, M., Fujii, C., Gaebel, W., Hegerl, U., Levav, I., Munk Laursen, T., Ma, H., Maj, M., Elena Medina-Mora, M., Nordentoft, M., Prabhakaran, D., ... Saxena, S. (2017). Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry, 16(1), 30-40. https://doi.org/10.1002/wps.20384

Liu, NH, Daumit, GL, Dua, T, Aquila, R, Charlson, F, Cuijpers, P, Druss, B, Dudek, K, Freeman, M, Fujii, C, Gaebel, W, Hegerl, U, Levav, I, Munk Laursen, T, Ma, H, Maj, M, Elena Medina-Mora, M, Nordentoft, M, Prabhakaran, D, Pratt, K, Prince, M, Rangaswamy, T, Shiers, D, Susser, E, Thornicroft, G, Wahlbeck, K, Fekadu Wassie, A, Whiteford, H & Saxena, S 2017, 'Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas', World Psychiatry, vol. 16, no. 1, pp. 30-40. https://doi.org/10.1002/wps.20384

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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.",

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AU - Dudek, Kenn

AU - Freeman, Melvyn

AU - Fujii, Chiyo

AU - Gaebel, Wolfgang

AU - Hegerl, Ulrich

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AU - Elena Medina-Mora, Maria

AU - Nordentoft, Merete

AU - Prabhakaran, Dorairaj

AU - Pratt, Karen

AU - Prince, Martin

AU - Rangaswamy, Thara

AU - Shiers, David

AU - Susser, Ezra

AU - Thornicroft, Graham

AU - Wahlbeck, Kristian

AU - Fekadu Wassie, Abe

AU - Whiteford, Harvey

AU - Saxena, Shekhar

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Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

Abstract

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