Health Disparities Among People With Serious Mental Illness

Published February 2020

The Psychiatric Services Editor’s Choice provides essential curated collections from recent issues of Psychiatric Services.  Each month, Editor Lisa Dixon and the Early Career Psychiatrist Advisory Committee offer a curated collection from the rich resource of articles published in the journal. Updates will focus on one area, summarizing for the researcher, clinician, and policy analyst the latest information and seminal research with links to specific content from Psychiatric Services.

People with serious mental illness face glaring health disparities, with mortality rates 2–3 times higher than those of the general population. This disparity translates to life expectancies shortened by 10–28.5 years. Cardiometabolic factors, including diabetes, hypertension, hyperlipidemia, and cardiovascular disease, are major drivers of this early mortality. These illnesses are both caused and compounded by smoking, lack of physical activity, poor nutrition, and social determinants that negatively affect the health of people with serious mental illness.

This collection begins with articles describing factors that affect the health and well-being of people with serious mental illness, including the prevalence of diabetes and obesity, high rates of smoking, and delays in seeking medical care. Subsequent articles highlight low rates of screening for cardiometabolic factors, communicable disease, and cancer among people with serious mental illness. Interventions to address these issues are highlighted, including smoking cessation efforts, involving peers to support patients with self-management in the Health and Recovery Peer Program (HARP), and group-based medical illness self-management with the Living Well initiative. The collection concludes with policy considerations to improve outcomes for people with serious mental illness, including a compelling argument for recognition of serious mental illness as a disparities category.

Please note that not all articles in this curated collection are available without a subscription. For access, learn about subscribing to Psychiatric Services.


Correlates of Co-Occurring Diabetes and Obesity Among Community Mental Health Program Members With Serious Mental Illnesses
Judith A. Cook, Ph.D., Lisa Razzano, Ph.D., C.P.R.P., Jessica A. Jonikas, M.A., Margaret A. Swarbrick, Ph.D., Pamela J. Steigman, M.A., Marie M. Hamilton, L.C.S.W., M.P.H., Tina M. Carter, B.A., Alberto B. Santos, M.D.
2016, Volume 67, Issue 11, pp. 1269–1271

Cigarette Smoking by Patients With Serious Mental Illness, 1999–2016: An Increasing Disparity
Faith Dickerson, Ph.D., M.P.H., Jennifer Schroeder, Ph.D., Emily Katsafanas, B.S., Sunil Khushalani, M.D., Andrea E. Origoni, B.A., Christina Savage, M.A., Lucy Schweinfurth, B.A., Catherine R. Stallings, R.N.C., M.A., Kevin Sweeney, B.S., Robert H. Yolken, M.D.
2018, Volume 69, Issue 2, pp. 147–153

Delays in Seeking General Medical Services and Measurable Abnormalities Among Individuals With Serious Mental Illness
Stanislav Spivak, M.D., Bernadette A. Cullen, M.B.B.Ch., B.A.O., William Eaton, Ph.D., Katie L. Nugent, Ph.D., Katrina Rodriguez, M.S., Ramin Mojtabai, M.D., Ph.D.
2018, Volume 69, Issue 4, pp. 479–482

Interventions to Improve Metabolic Risk Screening Among Adult Patients Taking Antipsychotic Medication: A Systematic Review
Osnat C. Melamed, M.D., M.Sc., Erin N. Wong, B.Sc., Laura R. LaChance, M.D., Sarah Kanji, B.Sc., M.Sc., Valerie H. Taylor, M.D., Ph.D.
2019, Volume 70, Issue 12, pp. 1138–1156

Low Rates of HIV Testing Among Adults With Severe Mental Illness Receiving Care in Community Mental Health Settings
Christina Mangurian, M.D., M.A.S., Francine Cournos, M.D., Dean Schillinger, M.D., Eric Vittinghoff, Ph.D., Jennifer M. Creasman, M.S.P.H., Bernard Lee, M.P.H., Penelope Knapp, M.D., Elena Fuentes-Afflick, M.D., M.P.H., James W. Dilley, M.D.
2017, Volume 68, Issue 5, pp. 443–448

Rates of Cervical Cancer Screening Among Women With Severe Mental Illness in the Public Health System
Monique James, M.D., Melanie Thomas, M.D., M.S., Latoya Frolov, M.D., M.P.H., Nicholas S. Riano, B.A., Eric Vittinghoff, Ph.D., Dean Schillinger, M.D., John W. Newcomer, M.D., Christina Mangurian, M.D., M.A.S.
2017, Volume 68, Issue 8, pp. 839–842

“Why Me?” Understanding the HCV Care Continuum Among People With Serious Mental Illness
Rachel M. Arnold, B.A., Hana Machover, B.S., Megan E. Wall, B.S., Ida Ahmadizadeh, B.S., Wendy Potts, M.S., Seth Himelhoch, M.D., M.P.H.
2018, Volume 69, Issue 11, pp. 1188–1190

Management of Common Medical Conditions by Office-Based Psychiatrists
Ramin Mojtabai, M.D., Ph.D., and Mark Olfson, M.D., M.P.H.
2018, Volume 69, Issue 4, pp. 410–423

Low-Burden Strategies to Promote Smoking Cessation Treatment Among Patients With Serious Mental Illness
Li-Shiun Chen, M.D., Sc.D., Timothy B. Baker, Ph.D., Jeanette M. Korpecki, R.Ph., Kelly E. Johnson, M.D., Jaime P. Hook, M.D., Ross C. Brownson, Ph.D., Laura J. Bierut, M.D.
2018, Volume 69, Issue 8, pp. 849–851

Peer-Led Self-Management of General Medical Conditions for Patients With Serious Mental Illnesses: A Randomized Trial
Benjamin G. Druss, M.D., M.P.H., Manasvini Singh, M.S.P.H., Silke A. von Esenwein, Ph.D., Gretl E. Glick, M.P.H., Stephanie Tapscott, M.S.W., Sherry Jenkins Tucker, M.A., Cathy A. Lally, M.S.P.H., Evelina W. Sterling, Ph.D.
2018, Volume 69, Issue 5, pp. 529–535

Systematic Review of Integrated General Medical and Psychiatric Self-Management Interventions for Adults With Serious Mental Illness
Karen L. Whiteman, Ph.D., John A. Naslund, M.P.H., Elizabeth A. DiNapoli, Ph.D., Martha L. Bruce, Ph.D., M.P.H., Stephen J. Bartels, M.D., M.S.
2016, Volume 67, Issue 11, pp. 1213–1225

Implementation of a Lifestyle Intervention for People With Serious Mental Illness in State-Funded Mental Health Centers
Stephen J. Bartels, M.D. M.S., Kelly A. Aschbrenner, Ph.D., Sarah I. Pratt, Ph.D., John A. Naslund, Ph.D., Emily A. Scherer, Ph.D., Lisa Zubkoff, Ph.D., Michael J. Cohen, M.A., Gail E. Williams, B.A., Rosemarie S. Wolfe, M.S., Kenneth Jue, M.S.S.A., Mary F. Brunette, M.D.
2018, Volume 69, Issue 6, pp. 664–670

Implementing a Whole Health Model in a Community Mental Health Center: Impact on Service Utilization and Expenditures
Ellen E. Bouchery, M.S., Allison Wishon Siegwarth, M.H.S., Brenda Natzke, M.P.P., Jennifer Lyons, A.M., Rachel Miller, M.P.A., Henry T. Ireys, Ph.D., Jonathan D. Brown, Ph.D., Elena Argomaniz, M.A., Rochelle Doan, M.S.
2018, Volume 69, Issue 10, pp. 1075–1080

Living Well: An Intervention to Improve Medical Illness Self-Management Among Individuals With Serious Mental Illness
Anjana Muralidharan, Ph.D., Clayton H. Brown, M.S., Ph.D., Jason E. Peer, Ph.D., Elizabeth A. Klingaman, Ph.D., Samantha M. Hack, Ph.D., Lan Li, M.S., Mary Brighid Walsh, M.A., Richard W. Goldberg, Ph.D.
2019, Volume 70, Issue 1, pp. 19–25

The Case for Severe Mental Illness as a Disparities Category
Matthew L. Goldman, M.D., M.S., Brigitta Spaeth-Rublee, M.A., Harold Alan Pincus, M.D.
2018, Volume 69, Issue 6, pp. 726–728

Simulated Effects of Policies to Reduce Diabetes Risk Among Adults With Schizophrenia Receiving Antipsychotics
Andrew W. Mulcahy, Ph.D., M.P.P., Sharon-Lise Normand, Ph.D., John W. Newcomer, M.D., Benjamin Colaiaco, M.Phil., Julie M. Donohue, Ph.D., Judith R. Lave, Ph.D., Emmett Keeler, Ph.D., Mark J. Sorbero, M.S., Marcela Horvitz-Lennon, M.D., M.P.H.
2017, Volume 68, Issue 12, pp. 1280–1287

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