Interventions To Improve Cardiovascular Risk Factors in People With Serious Mental Illness Executive Summary

Serious mental illness (SMI) is defined generally as a major mental or behavioral disorder, causing substantial impairment in multiple areas of daily functioning. SMI affects about 4 to 8 percent of adults1-3 and includes disorders such as schizophrenia and bipolar disorder but not isolated substance abuse or developmental disorders. Individuals with SMI have shortened life expectancies relative to the general population to an extent that is not explained by suicide and accidents alone.4,5 This population experiences higher rates of morbidity from multiple general medical conditions, including diabetes6-8 and cardiovascular disease (CVD).9-11 Among patients using the public mental health system, heart disease was the leading cause of death.12 This excess of CVD-related mortality may be due to a number of factors, including direct effects of the illness, medications used to treat SMI, modifiable behavioral risk factors, and disparities in access and quality of health care.