Health-risk behaviours among people with severe mental ill health: understanding modifiable risk in the Closing the Gap Health Study

Emily Peckham, Ben Lorimer, Panagiotis Spanakis, Paul Heron, Suzanne Crosland, Lauren Walker, Simon Gilbody

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BACKGROUND: People with severe mental ill health (SMI) experience some of the largest health inequalities of any sector within society. For these inequalities to be reduced, an understanding of the behavioural determinants of health in this population is needed.

AIMS: Utilising data from the Closing the Gap Health Study, we aimed to assess the extent to which people with SMI report health-risk factors and behaviours, their interest in modifying them, and the factors associated with being motivated to modify these behaviours.

METHOD: Adult (≥18 years old) participants were recruited via primary and secondary care in the English National Health Service. To be eligible, participants needed to have a documented diagnosis of schizophrenia, psychotic disorders or bipolar disorder. Data were collected by survey on demographics, general physical health, diet, physical activity, alcohol, smoking and body mass index.

RESULTS: Between April 2016 and March 2020, n = 9914 participants were recruited. Among people with SMI, high rates of obesity (37.5%), infrequent physical activity (62.0%), not meeting current guidelines (≥5) for the consumption of fruit and vegetables (85.0%) and smoking (42.2%) were observed. However, most participants were motivated to reduce health-risk behaviours. Perceiving the importance of health-promoting behaviours, being of poorer general health and being female were significantly associated with being motivated to modify health-risk behaviours.

CONCLUSIONS: Despite experiencing poor physical and mental health outcomes compared with the general population, and contrary to popular misconceptions, people with SMI perceive health as important and are motivated to make behavioural changes to improve health.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalBritish Journal of Psychiatry
Issue number4
Early online date18 Jan 2023
Publication statusPublished - 30 Apr 2023


  • Adult
  • Humans
  • Female
  • Adolescent
  • Male
  • State Medicine
  • Mental Health
  • Psychotic Disorders/epidemiology
  • Bipolar Disorder
  • Risk-Taking
  • Mental Disorders/epidemiology
  • health risk behaviours
  • schizophrenia
  • psychosis
  • bipolar disorder
  • Severe mental ill health


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