Severe Mental Illness

Healthwatch Herefordshire undertook interviews with 18 people with severe mental illness and around 20 organisations to understand the impact of SMI on daily life and access to healthcare. It found that living with SMI strongly affects everyday functioning, with most participants reporting low self-esteem, loneliness, stigma, and difficulty maintaining relationships. Many also had additional physical health conditions or disabilities, demonstrating a strong link between mental and physical health.

A key finding of the report is that mental and physical health interact in a cyclical way. When mental health deteriorates, individuals often struggle to maintain routines such as eating well, exercising, or attending appointments, which worsens physical health. In turn, poor physical health can further negatively impact mental wellbeing.

The report identifies multiple barriers to accessing healthcare. These include systemic issues such as long waiting times, fragmented services, and lack of continuity of care, as well as practical barriers like transport difficulties, digital exclusion, and limited awareness of available services. Emotional barriers, such as fear, stigma, and past negative experiences, also prevent people from seeking or continuing care.

Stigma and discrimination in healthcare settings were common experiences, with many participants feeling judged, dismissed, or not listened to. Diagnostic overshadowing was also reported, where physical health symptoms were wrongly attributed to mental health conditions, leading to missed or delayed diagnoses.

Access to ongoing support is limited, with over half of participants not receiving regular help beyond occasional GP contact. This contributes to inequalities and increases the risk of poorer health outcomes.

The report also highlights broader factors affecting health, including poverty, housing instability, and social isolation. Rurality in Herefordshire further compounds these challenges by limiting access to services.

To address these issues, the report recommends improving coordination between services through a single point of access, increasing proactive physical health monitoring, and expanding community-based and peer support. It also calls for better training for healthcare professionals to reduce stigma and improve understanding of SMI, as well as more accessible and flexible service delivery.

Overall, the report concludes that people with SMI in Herefordshire face complex and interconnected challenges, and that improving trust, accessibility, and person-centred care is essential to reducing health inequalities and improving outcomes.