Improving health and reducing health inequalities for people with severe mental illness: the 'Closing the Gap' Network+

患有精神分裂症和双相情感障碍等严重精神疾病的人比没有这种疾病的人平均早死20-25年。预期寿命缩短的原因是心脏病或糖尿病（及其并发症）或与生活方式因素相关的癌症。这一人群的吸烟率和肥胖率要高得多，患有SMI的人通常过着久坐不动的生活。住房条件通常很差，人们无法从锻炼和与自然环境互动中受益。一份名为《心理健康五年展望》（FYFV）的文件承认了改善身体健康的必要性，该文件将其描述为“英格兰最大的健康不平等之一”。这些复杂问题的任何解决方案都需要来自不同背景和不同技能的研究人员之间的合作。为了使研究产生影响，重要的是有SMI经验的人（以及那些照顾他们的人）从一开始就参与进来。约克大学有一批观点互补的研究人员，他们在历史上没有一起工作过。我们将开展研究，解决和减少这一死亡率差距。我们的计划是在所提供资金的帮助下发展我们的网络，我们将提供一个研究和合作计划。我们的活动将由一个具有地方、国家和国际专门知识的指导委员会监督。我们网络的初步活动将涉及四个工作领域。第一个由国际专家领导，研究人们如何与自然环境互动并从中受益（“绿色和蓝色空间”）。第二个工作领域将寻求利用记录的关于重度精神障碍患者如何使用卫生服务和自然环境的大量信息（“大数据”）的潜力。我们将在以前没有连接的数据之间建立链接。第三个工作领域将探索数字技术（如智能手机和“应用程序”）的潜力，以改善SMI患者的身体健康。第四个工作领域将探索艺术和创造力的潜力，以了解和改善重度精神障碍患者的身体健康和福祉。合作是该网络的核心，我们已经制定了一项计划，以确保研究人员共同努力，为死亡率差距问题找到创造性的解决方案。我们还确定了贯穿我们优先考虑的四个研究领域的问题。将每个主题联系起来的一个因素是重度精神障碍患者与其他人口相比所经历的不平等。我们已经招募了一个在这一领域有着良好记录的研究团队。我们的网络将持续四年。在此期间，我们将举办活动，鼓励合作，并在新成员加入网络。投资将刺激新的举措和合作。这一领域的研究具有挑战性，需要时间。我们的任务将变得更容易，因为我们为这项合作带来了一些资源，包括一群已经同意被邀请参加研究的SMI患者。在准备这次投标时，我们召集了来自NHS、社会护理服务、环境组织、地方政府、企业和志愿部门的合作伙伴。我们与一个代表精神病患者利益的重要国家慈善机构（精神健康基金会）建立了合作关系。从一开始，我们将考虑我们的研究成果如何在社会上产生影响。我们将CTG-Network+视为一个更大、更持久的工作计划的跳板，以解决重度精神障碍患者的健康不平等问题。当Network+的工作将在约克大学开始时，我们将确保与在英国（和国际）其他大学工作的人形成战略联盟。

People with severe mental illness (SMI) such as schizophrenia and bipolar illness die on average 20-25 years earlier than those without such disorders. The causes of reduced life expectancy are things such as heart disease or diabetes (and its complications) or cancers associated with lifestyle factors. Rates of smoking and obesity are much higher in this population, and people with SMI often lead sedentary lives. Housing is often poor, and people do not benefit from the opportunities offered by exercise and interaction with the natural environment.The need to improve physical health is recognised in a document known as the Five Year Forward View (FYFV) for Mental Health, where it is described as 'one of the greatest health inequalities in England'. Any solutions to these complex problems requires collaboration between researchers from different backgrounds and with different skills. For research to have impact, it is important that people with experience of SMI (and those who care for them) are involved from the outset. The University of York has a set of researchers with complementary perspectives who have not historically worked together. We will produce research that addresses and reduces this mortality gap. Our plan is to grow our Network with the help of the funds offered, and we will deliver a programme of research and collaboration. Our activities will be overseen by a steering committee with local, national and international expertise. The initial activities of our network will involve four areas of work. The first is led by international experts in how people interact with and benefit from natural environments ('green- and blue-space'). The second area of work will seek to harness the potential of the large amounts of information that are recorded on how people with SMI use health services and the natural environment ('big data'). We will make links between data that have not been connected before. The third area of work will explore the potential of digital technologies (such as smartphones and 'apps') to improve the physical health of people with SMI. The fourth area of work will explore the potential of the arts and creativity to understand and improve the physical health and wellbeing of people with SMI.Collaboration is at the centre of this Network, and we have put in place a plan to ensure that researchers work together to find creative solutions to the problem of the mortality gap. We have also identified issues which cut across the four research areas that we have prioritised. One factor which links each of the themes is the inequality that people with SMI experience when compared to the rest of the population. We have enlisted a research team with a very strong track record in this area. Our Network will run over four years. During this time we will hold events which will encourage collaboration and where new members are added to the Network. Investments will stimulate new initiatives and collaborations. Research in this area is challenging and takes time. Our task will be made easier because we bring to this collaboration a number of resources including a group of people with SMI who have already agreed to be invited to take part in research. In preparing this bid we have assembled partners from the NHS, social care services, environment organisations, local government, business and the voluntary sector. We have formed a collaboration with an important national charity who represent the interests of people with mental ill health (the Mental Health Foundation). From the beginning we will think about how the results of our research can have impact in society. We see the CTG-Network+ as a spring board for a much larger and long-lasting programme of work to address health inequality for people with SMI. Whist the work of the Network+ will start in the University of York, we will ensure that we form strategic alliances with people working in other universities in the UK (& internationally).