Department of Economics and Business Economics

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

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DOI

  • Nancy H Liu, Integrative Biology, University of California Berkeley, Berkeley, CA, USA
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  • Gail L Daumit, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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  • Tarun Dua, World Health Organization, Geneva, Switzerland.
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  • Ralph Aquila, Fountain House, New York, NY, USA.
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  • Fiona Charlson, 1] Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia [2] Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.
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  • Pim Cuijpers, Biological Psychology, Neuroscience Campus Amsterdam, Vrije Universiteit University and Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
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  • Benjamin Druss, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA; Winship Cancer Institute, Emory University, Atlanta, USA.
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  • Kenn Dudek, Fountain House, New York, NY, USA.
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  • Melvyn Freeman, National Department of Health, Johannesburg, South Africa.
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  • Chiyo Fujii, National Institute of Mental Health, Tokyo, Japan.
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  • Wolfgang Gaebel, Department of Gynaecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
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  • Ulrich Hegerl, Universitätsklinikum Leipzig, Leipzig, Germany.
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  • Itzhak Levav, Department of Natural Science, University of Haifa, Haifa, Israel.
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  • Thomas Munk Laursen
  • Hong Ma, Institute of Mental Health, Beijing, P.R. China.
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  • Mario Maj, Department of Psychiatry, University of Naples SUN, Naples, Italy.
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  • Maria Elena Medina-Mora, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
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  • Merete Nordentoft, University of Copenhagen, Copenhagen, Denmark.
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  • Dorairaj Prabhakaran, Public Health Foundation of India, Haryana, India.
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  • Karen Pratt, Fountain House, New York, NY, USA.
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  • Martin Prince, King's College London, Institute of Psychiatry
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  • Thara Rangaswamy, Schizophrenia Research Foundation, Chennai, India.
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  • David Shiers, Healthy Active Lives, Longsdon, Stoke-on-Trent, UK.
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  • Ezra Susser, Department of Astronomy, Columbia University, New York, NY 10027, USA
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  • Graham Thornicroft, King's College London, Institute of Psychiatry
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  • Kristian Wahlbeck, Finnish Association for Mental Health, Helsinki, Finland.
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  • Abe Fekadu Wassie, Addis Ababa University, Addis Ababa, Ethiopia.
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  • Harvey Whiteford, 1] Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia [2] Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.
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  • Shekhar Saxena, World Health Organization, Geneva, Switzerland.

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 languageEnglish
JournalWorld Psychiatry
Volume16
Issue1
Pages (from-to)30-40
Number of pages11
ISSN1723-8617
DOIs
Publication statusPublished - Feb 2017

    Research areas

  • Journal Article

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