10 March 2025

A growing and diverse body of evidence demonstrates that our health is influenced by a complex interaction between physical, emotional, social, and environmental factors.  

Individuals with severe mental illness (SMI) are at a significantly higher risk of developing respiratory conditions, which can impact overall wellbeing. Despite growing awareness of the need for holistic healthcare to address this, the divide between mental and physical health remains a challenge.  

The connection between mental and respiratory health is complex. Individuals with SMI - such as schizophrenia and bipolar disorder - are more likely to develop conditions like chronic obstructive pulmonary disease (COPD) and asthma, which lead to many preventable early deaths in this population.

Several factors contribute to this link, including: 

Lifestyle Factors: the prevalence of smoking among people with SMI has been estimated to be between 58% and 90%. With 72% of lung cancers in the UK being attributed to excessive tobacco use, highlighting the risk in this population3,4. Additionally, incidence of respiratory disease is seen to be higher in socially disadvantaged groups and in areas of social deprivation often attributed to higher smoking rates, exposure to higher levels of air pollution, poor housing conditions, and exposure to occupational hazards. 

Biological Factors: The physiological effects of chronic stress, medication side effects, and inflammation can make individuals with SMI more vulnerable to respiratory conditions. 

Healthcare Disparities: People with SMI often face barriers to accessing healthcare, leading to late diagnoses, inadequate treatment, and poorer health outcomes. 

KHP Mind & Body is driving the integration of mental and physical healthcare through evidencing and evaluating initiatives and implementing and scaling successful pilots. By understanding the interplay between psychological factors and physical respiratory health, we can support the implementation of interventions that address the ‘whole person’. For example, smoking cessation programs tailored for individuals with SMI, better screening for respiratory illnesses in psychiatric settings, and holistic care plans can all improve health outcomes for this population. 

A whole-person, integrated approach is essential to improving outcomes for individuals with SMI. By working to address lifestyle factors, reduce healthcare disparities, and implement comprehensive care strategies, we can create meaningful change.

To find out more about the KHP Mind & Body Programme, contact: charlotte.curry@slam.nhs.uk.  

References 

Goldman S, Saoulidi A, Kalidindi S, Kravariti E, Gaughran F, Briggs TW, Gray WK. Comparison of outcomes for patients with and without a serious mental illness presenting to hospital for chronic obstruction pulmonary disease: retrospective observational study using administrative data. BJPsych Open. 2023;9(4):e128. doi:10.1192/bjo.2023.522  

Suetani S, Honarparvar F, Siskind D, Hindley G, Veronese N, Vancampfort D, Allen L, Solmi M, Lally J, Gaughran F, Stubbs B. Increased rates of respiratory disease in schizophrenia: A systematic review and meta-analysis including 619,214 individuals with schizophrenia and 52,159,551 controls. Schizophrenia Research. 2021;237:131-140. https://doi.org/10.1016/j.schres.2021.08.022 

Peckham E, Lorimer B, Spanakis P, Heron P, Crosland S, Walker L, Gilbody S. Health-risk behaviours among people with severe mental ill health: understanding modifiable risk in the Closing the Gap Health Study. The British Journal of Psychiatry. 2023;222(4):160-166. https://doi.org/10.1192/bjp.2022.143.

Cancer Research UK. Lung cancer statistics. [Accessed 9 April 2024]. 

National Institute for Health and Care Research. Multiple long-term conditions (multimorbidity): making sense of the evidence. [Accessed 9 April 2024].