Mental health record database reaches 200,000 patients
The Clinical Record Interactive Search (CRIS) database now has over 200,000 fully-electronic, detailed, and anonymised mental health records, making it the most in-depth mental health data resource in Europe, and possibly the world.
CRIS was developed in 2008 through the National Institute of Health Research Biomedical Research Centre (NIHR BRC) for Mental Health at the South London and Maudsley NHS Foundation Trust and King’s College London. From its inception, the resource has been used to investigate health disparities faced by people with mental disorders.
Many studies have found that people with severe mental disorders, such as schizophrenia and bipolar disorder, have a much higher than expected risk of mortality. But only now, with unique access to in-depth mental health data through SLAM, researchers at King Institute of Psychiatry are beginning to ‘unpack’ this finding, identifying groups most at risk. An emerging pattern is that patients with the shortest life expectancies may be those who are least ‘visible’ to clinical services.
In 2010, the data from CRIS revealed that over a three year period people with severe mental illness had a mortality risk two times higher than people without severe mental illness. This increased to a four-fold higher risk of mortality for people with substance use disorders. In 2011, researchers calculated that this represented around 12 life years lost in severe mental illness and 14 life years lost in substance use disorders.
Further analysis of the data found, for example, that in people with substance use disorders, women with opioid use disorder and younger people with alcohol use disorder were found to be at highest risk of mortality. In groups with schizophrenia and bipolar disorder, recent research has indicated that severity of symptoms, such as delusions and hallucinations, was less important in predicting mortality than difficulties carrying out activities of daily living. Similarly, a person’s risk of suicide or violence, as rated by health professionals, was less important in predicting mortality than their risk of self-neglect.
Professor Rob Stewart, Head of Section of Epidemiology at King’s College London’s Institute of Psychiatry and Honorary Consultant in Liaison Old Age Psychiatry SLAM, led on the development of CRIS.
He says: “Clearly this reduced life expectancy is of profound importance for people affected by severe mental disorders and society as a whole. Difficulties with activities of daily living and self-neglect are common in people with severe mental illness, and it appears to be people with these characteristics who are most at risk. Traditionally, mental health services have focused on alleviating the most noticeable symptoms and on trying to reduce the risk of serious, but thankfully rare, outcomes such as suicide or violence to others. If services are to widen their remit towards improving life expectancy of the people they treat, there will need to be an active focus on people who may be perceived as less concerning in other respects.”
Professor Rob Stewart says: “Research of this kind illustrates the enormous value of information that can be found in health records. The studies described here would not have been possible without the CRIS data resource. The work has moved beyond diagnosis and we’re able to now look in more detail at symptom profiles and other detailed information which would not be available in general practice or routine hospital records.”
For further information, please contact Seil Collins, Press Officer, Institute of Psychiatry, King's College London, tel: 0207 848 5377 or email: seil.collins@kcl.ac.uk