Integrated care programmes for severe mental illnesses and comorbid physical health disorders: the EU-MIND umbrella review to inform future actions in Europe

Abstract

Evidence before this study People with severe mental illness (SMI) experience a markedly elevated burden of physical comorbidity and premature mortality. Although integrated care has long been proposed as a strategy to address fragmentation between mental and physical healthcare services, the organisational features of effective and scalable programmes remain unclear. We searched PubMed, Scopus, PsycINFO, and the Cochrane Library from database inception to 5 May 2026 for review-level evidence on integrated care programmes for individuals with SMI and co-occurring physical conditions or major social vulnerabilities. Search terms included combinations of “severe mental illness”, “serious mental illness”, “integrated care”, “collaborative care”, “coordinated care”, and “multimorbidity”. We included systematic reviews, scoping reviews, and meta-analyses restricted to seven predefined European languages. Existing reviews describe various integrated care approaches and report improvements in access to care and preventive services. However, evidence on physical health outcomes, governance, financing, and implementation processes, remains limited and inconsistently reported. Added value of this study This umbrella review provides a structured synthesis of the organisational components, reported impacts, and implementation challenges of integrated care programmes for people with SMI using the SELFIE framework for multimorbidity-oriented integrated care. By mapping these programmes across service delivery, governance, workforce, financing, technology, and research domains, we identify persistent system-level gaps that constrain scalability and sustainability. The review highlights the predominance of pilot-based initiatives and the limited evidence supporting improvements beyond care processes. Implications of all the available evidence Current evidence suggests that integrated care programmes can improve access to primary and preventive services for people with SMI, but their broader impact on physical health and social outcomes remains modest. Strengthening macro-level governance, sustainable financing mechanisms, digital infrastructure, and cross-sector coordination will be critical to translate promising pilot initiatives into scalable health system reforms. These findings inform the next phase of the EU-MIND initiative, which will engage stakeholders to develop consensus-based guidance for implementing sustainable integrated care across diverse European health systems.