Lessening the risk of cardiovascular disease in people with a severe mental illness

East London Foundation NHS Trust and City, University of London have proudly announced the launch of an innovative joint research initiative, PEGASUS, dedicated to lessening the risk of cardiovascular disease (CVD) in individuals with severe mental illness (SMI). Funded by the National Institute of Health and Care Research, PEGASUS is a five-year research programme that will commence in October 2023 and conclude in September 2028.

It is an unfortunate reality that those affected by serious mental illness tend to have a life expectancy 15-20 years shorter than the average population with CVD being the leading cause of death. Standard healthy lifestyle interventions, though effective in the general population, often fall short in helping those with SMI.

Additionally, side effects of psychiatric medication can exacerbate physical health complications. People from black and other ethnic minority communities can be at increased risk of both SMI and CVD, and this programme of research will have a workstream dedicated to working with communities to address health inequalities.

Involving Service Users

The PEGASUS programme is set to partner with current mental health service users, along with mental and physical health care professionals, in the co-creation of a group clinic. This clinic's objective is to mitigate CVD risk for all individuals with SMI. The research team includes members who have personally used mental health services, ensuring their unique insights are integrated into shaping the research direction.

Sharing Experience

These clinics will serve as a meeting point for mental and physical health experts, GPs, and voluntary sector organisations, helping individuals to set and reach personalised healthy lifestyle objectives while confirming the suitability of their medication. Each clinic will be jointly managed by a healthcare professional and a seasoned peer worker with previous experience in mental health services. The peer support worker's role will also include aiding individuals with SMI to fortify their social networks and feel more in control of their health and wellbeing.

Tackling Social Isolation

The PEGASUS team is committed to collaborating with local community groups to increase physical health awareness among those struggling with mental health issues, particularly in racialised communities. They will also strive to develop culturally sensitive behaviour change strategies for achieving a healthier lifestyle. A priority of the programme is to ensure equality of access to evidence-based care.

The PEGASUS approach will first be piloted before its effectiveness in decreasing CVD risk is evaluated 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.

The collaboration encompasses City, University of London, Queen Mary, University of London, University of Southampton, King’s College London and Kingston University, and will be delivered in association with mental health NHS Trusts in East London, North East London, Birmingham and Solihull, and Nottinghamshire.

About the funder

The National Institute for Health and Care Research (NIHR)

• The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
• Funding high quality, timely research that benefits the NHS, public health and social care;
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
• NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.