MEDIATE Booklet for general audience

MEDIATE: MEDIcation optimisATion in severE mental illness.

Medication, particularly anti-psychotics and mood stabilisers, are the main treatment options for people with severe mental illnesses (SMI), such as schizophrenia and bipolar disorder. Whilst helpful in controlling symptoms, these medications can lead to debilitating side effects and the development of additional diagnoses such as diabetes and cardiovascular disease. People with SMI often receive complex medication regimens to treat their mental and physical health needs.

Optimising these regimens can be challenging and the consequences of failing to do so can be devastating, both in terms of untreated mental illness and medication related side-effects, and can, in turn, increase the risk of non-adherence and relapse. Although collaborative approaches such as shared decision making are thought to positively influence medication optimisation, there is very little published research describing how medication decisions are determined for people living with SMI. MEDIATE was a 16 month long NIHR funded realist review, starting from November 2021 to March 2023, involving extensive stakeholder engagement with ‘experts-by-experience’ to make sense of the complexities and identify potential solutions.

This leaflet summarises MEDIATE.