Physical and sexual health

There are many associations between physical and mental health, they are considered bi-directional and intricately linked. The Healthy Active Lives declaration is an international consensus focusing on tackling physical health in young people experiencing mental ill-health. It outlines a set of key principles and processes that support the goal of maintaining good physical health.

People with psychosis face a reduction in life expectancy of up to 20 years compared with the general population. This gap is largely due to physical health conditions, such as cardiovascular disease, rather than suicide, and it is widening. Poor cardiometabolic health is prevalent among people with schizophrenia, and is a result of a mixture of factors, including side effects of medication, lifestyle-related factors such as poorer diet, higher smoking rates and reduced physical activity, and wider socioeconomic factors that are associated with psychosis, such as poverty, poorer access to health care, social isolation and marginalisation.

Adolescence is a key stage of physical, emotional and social development, when young people transition from childhood, mature physically, and begin to develop adult identities and behaviour. The key challenges of adolescence include more than just the physical changes of puberty; young people also begin in this stage to develop a sense independence, personal identity, healthy values and attitudes and a strong social support network. Sexual health, sexual identity and sexual behaviour are all key parts of every person’s life and personal development.

This clinical practice guide covers the screening, assessment and management of physical health problems in young people, with a specific focus on cardiometabolic health and sexual health. The purpose of this guide is to provide an overview of the evidence relating to cardiometabolic and sexual health in young people with mental health problems, and to provide guidance around appropriate and effective interventions.

This resource has been developed for clinicians to summarise the latest evidence related to sexuality diversity; risk and protective factors that can influence the mental health of sexuality diverse young people; and sexuality diverse young peoples’ experiences of seeking support for mental health issues.It is designed to support clinicians to work with young people in a way that is safe and inclusive by considering how to ensure inclusion for sexuality diverse young people at a service- and clinical-level (i.e. one-on-one).