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New research to reduce risk of cardiovascular disease in people with severe mental illness

Published: 19 June 2023

NIHR has invested £2m into a new study dedicated to lessening the risk of cardiovascular disease (CVD) in people with severe mental illness (SMI).

The study, known as PEGASUS, is a collaboration between East London Foundation NHS Trust and City and University of London.

It is an unfortunate reality that people with SMI can die 15-20 years younger than the general population. CVD including heart disease is the biggest cause of early death for people with SMI. 

Standard health lifestyle advice is effective in the general population. Yet, it often falls short in helping those with SMI. Also, side effects of psychiatric medication can worsen physical health complications. People from Black and ethnic minority communities can be at increased risk of both CVD and SMI.

This study is developing a group clinic to reduce CVD for people with SMI. The initial pilot of group clinics will be for 10 people in each of four mental health Trusts. It will include a workstream dedicated to working with communities to address health inequalities. The research team includes members who have personally used mental health services. This ensures their unique insights shape the research direction.

What is a group clinic?

The approach includes the co-creation of a group clinic by current mental health service users and mental and physical health professionals. This clinic’s goal is to reduce CVD risk for people with SMI. They will achieve this by offering personalised, goal-oriented exercise and diet advice from physical healthcare professionals. They will also monitor and review psychiatric medication. Peer workers will offer individual peer support to empower people and reduce social isolation. 

Each clinic will be managed by a healthcare professional and seasoned peer worker. The seasoned peer worker will have previous experience in mental health services. The clinic will also serve as a meeting point for mental and physical health experts, GPs, and voluntary sector organisations. 

Collaborating with local communities

The PEGASUS team have a commitment to collaborate with local community groups to increase physical health awareness for people with mental health issues. They are particularly focused on racialised communities. Health awareness workshops will aim to increase participation from marginalised communities. This will support the development of culturally sensitive behaviour change strategies. These will aim to achieve a healthier lifestyle. A priority of the programme is to ensure equality of access to evidence-based care.

The PEGASUS approach will be piloted first. This will be followed by an evaluation of its effectiveness to decrease CVD risk in a multi-site, randomised clinical trial.

“The intervention is trying to tackle social isolation as a key motivational factor”; said Professor Frank Röhricht, Consultant Psychiatrist and Medical Director at East London NHS Foundation Trust “In the PEGASUS programme, we will work with people using mental health services, and mental and physical health care professionals to co-design a group clinic that aims to reduce risk of CVD for all people with SMI and to tackle social isolation as well as poor subjective quality of life in an integrated way.”

Co-leading the programme, Professors Steve Gillard and Stanton Newman from City, University of London, shared their enthusiasm about the initiative.

Professor Gillard said, "We are excited about the potential of PEGASUS to bring about a transformation in the way we approach healthcare for people with severe mental illness. By actively involving communities in the process, we believe we can make a significant impact on the health and wellbeing of this vulnerable group of people."

Professor Newman added, "PEGASUS is not just a research programme; it is a commitment to improving the health and quality of life for people with severe mental illness. We are committed to creating a healthcare system that is more inclusive, effective, and responsive to the needs of all patients."

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