Cited by 865Mental Health Treatment and AccessSuicide and Self-Harm StudiesPsychiatric care and mental health services

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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

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Liu, Nancy H., Daumit, Gail L., Dua, Tarun, Aquila, Ralph, Charlson, Fiona, Cuijpers, Pim, Druss, Benjamin, Dudek, Kenn, Freeman, Melvyn, Fujii, Chiyo, Gaebel, Wolfgang, Hegerl, Ulrich, Levav, Itzhak, Munk Laursen, Thomas, Ma, Hong, Maj, Mario, Elena Medina‐Mora, Maria, Nordentoft, Merete, Prabhakaran, Dorairaj, Pratt, Karen, Prince, Martin, Rangaswamy, Thara, Shiers, David, Susser, Ezra, Thornicroft, Graham, Wahlbeck, Kristian, Fekadu Wassie, Abe, Whiteford, Harvey, Saxena, Shekhar·2017·World Psychiatry

DOI 10.1002/wps.20384PMC PMC5269481

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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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Authors: 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., Pratt, K., Prince, M., Rangaswamy, T., Shiers, D., Susser, E., Thornicroft, G., Wahlbeck, K., Fekadu Wassie, A., Whiteford, H., & Saxena, S.
Affiliations: World Health Organization (CH)
Johns Hopkins University (US)
Fountain House New York NY USA
Queensland Centre for Mental Health Research (AU)
Vrije Universiteit Amsterdam (NL)
Emory University (US)
National Department of Health Johannesburg South Africa
National Institute of Mental Health (JP)
Heinrich‐Heine‐University Düsseldorf Düsseldorf Germany
University Hospital Leipzig (DE)
University of Haifa (IL)
Aarhus University Aarhus Denmark
Institute of Mental Health Beijing P.R. China
University of Naples Federico II (IT)
National Institute of Psychiatry Ramón de la Fuente Muñiz Mexico City Mexico
University of Copenhagen (DK)
Public Health Foundation of India (IN)
King's College London (GB)
Schizophrenia Research Foundation Chennai India
Healthy Active Lives Longsdon Stoke‐on‐Trent UK
Columbia University (US)
MIELI Suomen mielenterveys ry (FI)
Addis Ababa University Addis Ababa Ethiopia
ORCID: Liu, Nancy H.
Daumit, Gail L.
Dua, Tarun
Charlson, Fiona
Cuijpers, Pim
Druss, Benjamin
Freeman, Melvyn
Fujii, Chiyo
Hegerl, Ulrich
Ma, Hong
Maj, Mario
Nordentoft, Merete
Prabhakaran, Dorairaj
Pratt, Karen
Prince, Martin
Shiers, David
Susser, Ezra
Thornicroft, Graham
Wahlbeck, Kristian
Whiteford, Harvey
Saxena, Shekhar
Venue: World Psychiatry
Publisher: Wiley
Published: 2017-01-26
Volume: 16
Issue: 1
Pages: 30-40
ISSN: 1723-8617 (ISSN-L)
2051-5545
DOI: 10.1002/wps.20384
PMC: PMC5269481
OpenAlex: W2580206093
Cited by: 865
References: 85
Citations by year: 2026: 57 · 2025: 73 · 2024: 89 · 2023: 102 · 2022: 99 · 2021: 93 · 2020: 87 · 2019: 62 · 2018: 169 · 2017: 31
FWCI: 136.60
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: World Psychiatry (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
VU Research Portal (publishedVersion, other-oa)
Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Research Portal (King's College London) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: World Health Organization
National Institute for Health and Care Research (NF-SI-0611-10053)
Lundbeckfonden (R155-2014-1724)
National Institute of Mental Health (K24MH093763)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords: excess mortality, severe mental illness, multilevel models, risk factors, intervention framework, health system interventions, community-based intervention, policy priorities, research priorities

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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

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