Little is known about the physical co-morbidity in mentally ill living in psychiatric and social health care facilities with regard to variation, causes, risk factors and prevention strategies. Aim of this study was to determine patients’ and professionals’ perceptions, attitudes and thoughts of (i) co-morbid physical health problems and illness, (ii) risk factors and causes of somatic problems and (iii) prevention measures across Europe.

A total of 52 focus groups in 14 European countries were conducted. Participants were recruited from psychiatric and social health care facilities. Data were content analyzed deductively and inductively.

The physical health problems that were often mentioned were weight problems, diabetes, cardiovascular and gastrointestinal problems, problems of the circulatory system, and general aches and pains. Regarding the causes of somatic problems and illnesses, focus groups repeatedly emphasized side-effects from medications. Besides treatment-related factors, country-specific aspects also were mentioned, mainly in the field of the living environment. Findings concerning “prevention” demonstrated the greatest distinctions between the participant groups, particularly with regard to the implementation and realization of health promotion interventions. Discussions revealed that patients preferred active learning (hands-on experiences) coupled with group classes for education and social support.

Focus groups identified behavioural, environmental and iatrogenic health risks. Efforts need to be directed toward interventions for physical illness prevention and health promotion on the background of the heterogeneity of mental disorders and the multitude of physical problems, and need to be based on an understanding of residents’ cultural beliefs and life situations.