Search results

ObjectivesTo examine differences in hospital admissions for people with severe mental illness (SMI), physical health multimorbidity and mortality compared to the general hospital population without SMI.
ApproachThis study linked electronically captured routine administrative data from Northern Ireland (from 2013-2021): this comprised hospital records (including diagnostics codes); community prescribed medications; standard indicators of social deprivation (NIMDM); mortality data (General Register Office); and associated demographic data. The population included for analysis comprised 1,153,447 persons registered with a general practice at 01/01/2010 who subsequently attended a hospital setting. SMI was classified as a binary variable.
ResultsThe population comprised 933,816 hospital patients aged 20plus at 2010, 414,887 (44.4%) males and 518,929 (55.5%) females – with 13,920 (1.5%) recording SMI: 6492 (46.6%) males and 7433 (53.4%) females between 2010 and 2021. Of these 7620 (54.7%) recorded schizophrenia; 4138 (29.7%) bi-polar disorder; and 2162 (15.5%) personality disorder. Those in the most deprived and those in urban areas were more likely to record SMI than their respective least deprived or rural peers (OR=2.38:95%CI=2.39-2.59 and OR=2.04:1.94-2.14). Increasing multimorbidity was associated with increasing SMI diagnosis: after adjustment for age, sex and year of exposure those with 5plus morbid states recorded OR=2.85(2.44-3.33) and OR=3.74(3.26-4.29) for 2012 and 2020 respectively. Finally, in models adjusted for age, sex and multimorbidity, those with SMI were more likely to die than their non-SMI peers: OR=2.09(1.92-2.29) for the 2012 group.
ConclusionPhysical health multimorbidity and mortality increased in SMI compared to the non-SMI diagnosed group. We suggest a range of morbidities associated with SMI can drive excess mortality. This study highlights the importance to examine the extent of underdiagnosis of the causes of mortality in SMI presenting insights into suitable interventions.
AcknowledgementThe authors would like to acknowledge the help provided by the staff of the Honest Broker Service (HBS) within the Business Services Organisation Northern Ireland (BSO). The HBS is funded by BSO and the Department of Health (DoH). The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the author and do not necessarily represent those of the BSO.

This article uses a qualitative approach to elicit the views of 31 professionals who provide services to vulnerable young men. The findings reveal six key themes following focus group interviews: (i) the importance of masculinity in explaining problematic behaviour; (ii) the misuse of alcohol and drugs; (iii) alienation and social isolation; (iv) concerns about suicide and self‐harm; (v) the quality of existing services; and (vi) recommendations for changes to services. Service providers generally acknowledged the social context in explaining these behaviours and argued for enhanced services and a more developed skills base in working with vulnerable young men.

BackgroundA combination of increased life expectancy and improvements in childhood survival rates has resulted in a persistent increase in the population at risk of chronic conditions and multimorbidity (WHO, 2016). Relatively little is known about levels of multi-morbidity, combinations of multi-morbid disorders or risk factors among the Northern Ireland (NI) population.
ObjectivesThis study aims to estimate rates of multi-morbidity among adults aged 25 and over in the NI population and examine the association of multi-morbidity and combinations of multimorbid conditions with a range of social determinants.
MethodsAnalyses are based on 1,123,604 individuals enumerated in the 2011 NI census, aged 25-64 and 65 plus. Descriptive statistics report prevalence rates and logistic regression examined the association between social determinants and multi-morbidity.
ResultsOverall, 40.08% reported at least one health condition, while 19.23% reported multi-morbidity. Results confirm a clear social gradient and association between age and multi-morbidity. Multi-morbidity was more likely among females aged 25- 64 (OR=1.09), but less likely among females aged 65 plus (OR=0.93). Marriage was protective among those aged 25- 64, while those who were never married had lower risk among those aged 65 plus (OR=0.64). Further analyses exploring social determinants of morbidity profiles present a complex array of associations. Among 25-64 year olds, while females were more likely to report single mental and less likely to report single physical problems, they were less likely to report multiple mental conditions and more likely to report combined physical/mental conditions.
ConclusionsResults suggest that multi-morbidity is common among the NI adult population and is a public health issue across the lifespan. While studies assessing the validity of self-reported health conditions within census are required, findings provide tentative evidence of the complex nature of associations between social determinants and multi-morbidity and how these vary among younger and older adults.

The Scoping Study was initiated in response to the Programme for Government 2016-2021 indicator, 'Improve the quality of life for people with disabilities and their families'. The Disability Research Network was approached to assist the Department for Communities in the development of this indicator. The scoping study included 5 objectives: (1) To review the international literature on quality of life (QoL) measurements for people with disabilities and their families; (2) To develop recommendations for key definitions; (3) To assess existing and emerging data sources for potential use; (4) To develop recommendations for a preferred option; and (5) To test the recommended QoL measure.

The UK's National Health Service (NHS) generates uniquely rich data that should be rapidly deployed for policy and service improvement, yet researchers report difficulties in accessing these data. Paradoxically, these restrictions are occurring at the same time as the open science movement, which encourages data sharing to improve the rigour, transparency, and replicability of research. We describe the urgency of improvements to data access and propose solutions from a mental health research perspective, although the issues discussed extend to all areas in which analysis and linkage of health data support policy and practice. Actions are needed at every level, from data users and data custodians to government (panel).