Impact of socioeconomic deprivation on rate and cause of death in severe mental illness

Martin, Julie Langan; McLean, Gary; Park, John; Martin, Daniel J.; Connolly, Moira; Mercer, Stewart W; Smith, Daniel J.

doi:10.1186/s12888-014-0261-4

Cited by 51 publications

(43 citation statements)

References 38 publications

(43 reference statements)

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“…Our findings indicate that, for all mental health disorders, the absolute and relative difference in diabetes rates are exacerbated by increasing level of deprivation, highlighting the additional vulnerability of people with a mental illness who live in deprived areas. Previous Scottish studies have found that the excess mortality associated with severe mental illness is most marked in the most deprived population groups (31), and that multimorbidity, including mental-physical health comorbidity is more prevalent among more deprived groups (32). By demonstrating that the association between mental disorder and type 2 diabetes varies markedly by deprivation level, our study suggests that this increased diabetes risk is due largely to modifiable factors rather than intrinsic physiological effects of the mental illness itself.…”

Section: Interpretation In Context Of Previous Studiessupporting

confidence: 55%

Incidence of Type 2 Diabetes in People With a History of Hospitalization for Major Mental Illness in Scotland, 2001–2015: A Retrospective Cohort Study

et al. 2019

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OBJECTIVE To determine the incidence of type 2 diabetes in people with a history of hospitalization for major mental illness versus no mental illness in Scotland by time period and sociodemographics. RESEARCH DESIGN AND METHODS We used national Scottish population-based records to create cohorts with a hospital record of schizophrenia, bipolar disorder, or depression or no mental illness and to ascertain diabetes incidence. We used quasi-Poisson regression models including age, sex, time period, and area-based deprivation to estimate incidence and relative risks (RRs) of diabetes by mental illness status. Estimates are illustrated for people aged 60 years and in the middle deprivation quintile in 2015. RESULTS We identified 254,136 diabetes cases during 2001–2015. Diabetes incidence in 2015 was 1.5- to 2.5-fold higher in people with versus without a major mental disorder, with the gap having slightly increased over time. RRs of diabetes incidence were greater among women than men for schizophrenia (RR 2.40 [95% CI 2.01, 2.85] and 1.63 [1.38, 1.94]), respectively) and depression (RR 2.10 [1.86, 2.36] and 1.62 [1.43, 1.82]) but similar for bipolar disorder (RR 1.65 [1.35, 2.02] and 1.50 [1.22, 1.84]). Absolute and relative differences in diabetes incidence associated with mental illness increased with increasing deprivation. CONCLUSIONS Disparities in diabetes incidence between people with and without major mental illness appear to be widening. Major mental illness has a greater effect on diabetes risk in women and people living in more deprived areas, which has implications for intervention strategies to reduce diabetes risk in this vulnerable population.

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Section: Interpretation In Context Of Previous Studiessupporting

confidence: 55%

Incidence of Type 2 Diabetes in People With a History of Hospitalization for Major Mental Illness in Scotland, 2001–2015: A Retrospective Cohort Study

et al. 2019

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“…The SIMD is widely accepted as a means through which scarce government resources can be directed to areas with greatest need across Scotland, and the measure is used extensively in research and audit of health and social care services. While SIMD is the current deprivation measure used in Scotland, there is a suggestion that the broad domains used to measure aspects of the populations health and well‐being are not comprehensive enough (Allik, Brown, Dundas, & Leyland, ; Martin et al., ; Nicholson & Hotchin, ).…”

Section: Methodsmentioning

confidence: 99%

Patterns of referral and waiting times for specialist Child and Adolescent Mental Health Services

Smith

Kyle

Daniel

et al. 2017

Child Adoles Ment Health

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Background: During 12-month period (2012/13) around 21,480 children and young people (CYP) were referred to Child and Adolescent Mental Health Service (CAMHS) in Scotland (NHS Scotland, 2013, Child and Adolescent Mental Health Services waiting times in Scotland). At the end of September 2012, there were 3,602 CYP still waiting for 'start of treatment' or 'removal from the waiting list', 375 (10%) CYP had waited over 26 weeks and 1,204 (33%) CYP had waited over 18 weeks (NHS Scotland, 2013, Child and Adolescent Mental Health Services waiting times in Scotland). Referral source, referral reason and the sociodemographic characteristics of CYP are not routinely collected, and therefore, associations between these factors and wait times for 'start of treatment' or 'removal from the waiting list' (i.e. the referral outcome) are unknown. Method: In this exploratory study, a retrospective analysis of referral data was conducted in one CAMHS. Data for 476 referrals between 1st May 2013 and 31st May 2014 were initially analysed to define categories for each of the following key variables: referral source, referral reason and referral outcome. Data on CYP sociodemographic characteristics were extracted from referral records, including age, gender and postcode, from which Scottish Index of Multiple Deprivation quintile of residence was derived. Descriptive statistics were calculated for referral source, referral reason and CYP sociodemographic characteristics. Regression models were then built to determine predictors of a referral being rejected by CAMHS and waiting time for referrals accepted by CAMHS. Data were analysed in SPSS (Version 20). Results: Of the 476 referrals, 72% (n = 342) were accepted and 12% (n = 59) were rejected. Most referrals were made by general practitioners. Just under a third of referrals to CAMHS (31%) were for CYP with emotional and behavioural difficulties. The odds of being rejected by CAMHS were significantly higher if referred by teachers and for CYP with emotional and behavioural difficulties. Age and referral reason were significant independent predictors of waiting time after referral to CAMHS, with CYP referred for hyperactivity/inattention waiting significantly longer. Conclusions: Policymakers should consider ways to foster dialogue and collaboration between different groups of professionals making and accepting referrals to CAMHS in order to improve timely access to appropriate mental health support services for CYP. Research is urgently needed to investigate the experiences of CYP who are either rejected by CAMHS or wait lengthy periods of time before starting their treatment with CAMHS. Key Practitioner Message• Child and Adolescent Mental Health Services (CAMHS) are key supportive services for children and young people (CYP) with mental health difficulties.• Children and young people who are referred to this CAMHS by teachers were more likely to be rejected than those referred by medical professionals.• Children and young people with emotional and behavioural problems were more like...

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“…Unemployment and alcohol misuse are also common and are related to risk of cardiovascular disease . Importantly, the downward socio‐economic drift often associated with schizophrenia is in itself likely to increase the risk of ill health .…”

Section: Reasons For Excess Mortality and Morbiditymentioning

confidence: 99%

Promoting physical health for people with schizophrenia by reducing disparities in medical and dental care

Moore¹,

Shiers

Daly

et al. 2015

Acta Psychiatr Scand

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The goal was to reduce the mortality gap through equity of access to all levels of health care, including acute care, long-term condition management, preventative medicine and health promotion. We suggest solutions to promote health, wellbeing and longevity in this population, prioritising identification of and intervention for risk factors for premature morbidity and mortality. Shared approaches are vital, while joint education of clinicians will help break down the artificial mind-body divide.

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Impact of socioeconomic deprivation on rate and cause of death in severe mental illness

Cited by 51 publications

References 38 publications

Incidence of Type 2 Diabetes in People With a History of Hospitalization for Major Mental Illness in Scotland, 2001–2015: A Retrospective Cohort Study

Incidence of Type 2 Diabetes in People With a History of Hospitalization for Major Mental Illness in Scotland, 2001–2015: A Retrospective Cohort Study

Patterns of referral and waiting times for specialist Child and Adolescent Mental Health Services

Promoting physical health for people with schizophrenia by reducing disparities in medical and dental care

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