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The purpose of this paper by Gina Campion and Valerie Francis et al is to examine the health behaviours, health beliefs, and motivation to change in people with severe mental illness (SMI). A sample of people with SMI (n=43) and a control group (n=39) was recruited. All participants completed the Reported Health Behaviours Checklist (Prochaska et al, 1985). Half of the sample answered additional smoking related questions based on the Stages of Change model (Di Clemente et al, 1991) and half answered physical activity related questions based on Becker's (1974) Health Belief Model. The SMI sample was found to engage less often in health behaviours than controls. Significantly more of the SMI sample were in the early stages of change in relation to smoking and were found to be less intrinsically motivated to engage in regular physical activity than controls. This sample of people with SMI engaged in fewer health behaviours; did not consider themselves at risk of physical health problems and were not motivated to change their unhealthy lifestyles. Attention is drawn to the usefulness of theoretical models from health psychology in furthering research amongst this vulnerable patient sample

There is a growing body of research evidence to show that people with severe mental illness (SMI) have elevated risks for both physical morbidity and premature mortality (Dixon et al, 1999). There is also evidence that care staff and patients tend to overlook physical healthcare needs (Brugha, Wing and Smith, 1989) and health professionals have been urged to pay greater attention to the physical health of people with SMI. Of the various factors that have been proposed to account for the excess risk, suicide is usually presented as the single largest cause of preventable death. However, suicide accounts for only about one third of the excess risk (Brown, Inskip and Barraclough, 2000) and recent data concludes that lifestyle behaviours play a significant role. Smoking, physical inactivity and poor nutrition, which have been shown to significantly increase the risk of life threatening diseases, are more prevalent in those with SMI such as schizophrenia (Brown et al., 1999; Farnam et al, 1999).

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