Role and principles
Turn physical-health screening in severe mental illness into practical prevention, recognise cardiometabolic disease without diagnostic overshadowing, and assign follow-up actions that reduce avoidable illness and premature death.
People with severe mental illness experience a substantial burden of preventable physical disease. The causes include smoking, cardiometabolic risk, poverty, disrupted sleep, medicine effects, reduced access to care and diagnostic overshadowing. Individual behaviour is only part of the explanation. A person may want to exercise but lack safe local space, or understand dietary advice while depending on limited food choices. Effective prevention identifies these barriers and offers practical support.
The annual physical-health check provides a structured opportunity to detect risk and reconnect care. Its core components are a starting point, not a ceiling on clinical assessment. Ask about symptoms, family history, known cardiovascular or respiratory disease, medication, sleep, diet and activity. Review whether routine screening and vaccinations are accessible. Use a respectful approach to weight and alcohol, asking permission and linking the discussion to goals that matter to the person.