Researchers from the University of Bristol and partner institutions reviewed evidence from 12 international studies to understand which approaches help more people with SMI access routine physical health reviews. They examined a range of interventions, including case‑management, financial incentives, service changes and patient invitations.
What the study found
- Case‑management shows the most promise
Two high‑quality trials found that having a dedicated professional support patients through their health checks led to better uptake. However, one of these studies had a high risk of bias, meaning more rigorous research is still needed. - Other interventions give mixed results
Financial incentives, service‑level changes, and patient invitations sometimes improved uptake, but the evidence was inconsistent. Many of these studies were non‑randomised and varied in quality, making it difficult to draw firm conclusions. - Evidence remains limited
Out of more than 4,400 studies screened, only 12 met the criteria for inclusion, highlighting a major gap in high‑quality research on this important issue.
Why this matters
People with SMI, such as schizophrenia or bipolar disorder, often experience significant barriers when accessing healthcare. Improving access to physical health checks is an essential step toward reducing health inequalities and preventing early deaths.
Dr Elizabeth Emsley, Academic Clinical Fellow at the Centre for Academic Primary Care, University of Bristol and lead author, said: “There is a need for stronger, more robust studies to understand how best to support individuals with SMI. While case‑management appears promising, high‑quality trials are urgently needed to confirm what works and to help healthcare services take effective action."
About the study
The research team conducted a systematic review of studies published from 2000 onwards, covering primary, secondary and tertiary care settings in high‑income countries. The review assessed interventions that aimed to increase uptake of physical health checks or screening, including cancer screening, for people with SMI.
Paper: Increasing uptake of physical health checks for people living with severe mental illness: a systematic review. Elizabeth Emsley, Sarah A Sullivan, Elizabeth Rose-Innes, Emma Sidebotham and Clare E. French. Published in British Journal of General Practice. January 2026.