Cambridge & Birmingham

Ben Perry
Academic lead
Sarah Markham & Richard Mandunya
Co-production leads

Predicting adverse physical effects of anti-psychotic medication

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Objectives

1

Primary: We will investigate how information about future cardiometabolic health risks can be communicated clearly and sensitively to young people who have experienced psychosis. Our aim is to support understanding, minimise distress, and strengthen shared decision-making in clinical care..

2

Exploratory: We will examine how the PsyMetRiC clinical risk prediction tool can be incorporated into conversations between clinicians, young people, and carers in ways that encourage early prevention of physical health problems associated with severe mental illness.

What we are doing

We are working with young people who have experienced psychosis, their family members or carers, and healthcare professionals to understand how discussions about physical health risks currently take place in mental health services. Using in-depth interviews and structured group discussions, we are exploring how individuals interpret personalised risk information, what kinds of explanations or visual materials are most helpful, and how clinicians can communicate risk constructively and supportively.

People who experience psychosis have an increased likelihood of developing long-term physical health conditions, including cardiovascular disease and diabetes. These risks can emerge early in the course of illness and contribute to reduced life expectancy among people with severe mental illness. Although predictive approaches such as PsyMetRiC create opportunities for earlier intervention, there is limited evidence about how best to present risk estimates in ways that are empowering rather than overwhelming.

Through qualitative and co-production methods, we are examining how young people make sense of future health risk and how this information shapes emotional responses, motivation, and engagement with care. Participants may also use creative approaches, such as body-mapping, to help express their perspectives and experiences.

By bringing together the views of service users, carers, and clinicians, we aim to develop a shared understanding of what constitutes meaningful communication about different levels of physical health risk, and how these categories should inform monitoring, prevention, and treatment decisions.

Lived experience is central to the project. Young people with experience of psychosis are involved not only as participants but also as collaborators contributing to study design, data collection, interpretation, and dissemination. Their perspectives help ensure that the research remains grounded in real-world priorities and produces outcomes relevant to practice.

What we are planning to do

We will use the findings from interviews and stakeholder discussions to co-produce practical communication resources to support conversations about cardiometabolic risk. Working with lived-experience advisors, healthcare professionals, and design specialists, we will develop visual guides, structured conversation prompts, and digital materials to present personalised risk information clearly and sensitively.

These resources will be designed for use alongside the PsyMetRiC risk calculator in routine mental health care. Improving how risk is explained and understood has the potential to strengthen shared decision-making, support preventive interventions, and enable young people to play an active role in protecting their long-term physical health.

Following development, we will assess whether these approaches could enhance the clinical usefulness of cardiometabolic risk prediction and contribute to improved health outcomes for people with psychosis.

Find out more

There is growing international recognition that improving the physical health of people with severe mental illness requires earlier and more effective prevention strategies. Cardiometabolic conditions such as cardiovascular disease and type 2 diabetes are major contributors to reduced life expectancy in this population and often begin to develop during adolescence or early adulthood, particularly following the onset of psychosis.

Advances in clinical prediction modelling have led to tools such as PsyMetRiC, which use routinely collected health information to estimate an individual’s future risk of cardiometabolic illness. While these tools may help identify young people who could benefit from targeted monitoring or preventive care, their real-world value depends not only on predictive accuracy but also on how risk information is communicated and understood.

Evidence from wider health research shows that personalised risk information can influence behaviour, treatment engagement, and wellbeing in complex ways. Clear and supportive communication may enhance motivation and self-management, whereas poorly delivered information can increase anxiety or disengagement. However, relatively little research has explored how young people experiencing psychosis prefer these conversations to take place.

By integrating perspectives from mental health research, health communication science, and lived experience, this project contributes to an emerging field focused on improving preventive care in psychosis. The findings will help inform future clinical practice, service design, and research aimed at reducing avoidable physical health inequalities in severe mental illness.

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