Background: Some psychiatric illnesses tend to predispose patients to metabolic syndrome. Some psychiatric medications have been linked with an elevated risk of metabolic syndrome. Metabolic syndrome has an increased risk of cardiovascular disease and type 2 diabetes.

Method: The following data were obtained from the last 6 months’ medical notes of inpatients in two rehabilitation units: waist circumference; BP; fasting blood tests: triglycerides, HDL cholesterol and glucose; psychiatric and medical diagnoses and medication.

Results: 58% of the patients met the criteria for metabolic syndrome. However, due to lack of appropriate physical monitoring in some cases, only 19% had previously been diagnosed. Therefore not all the patients with metabolic syndrome were being appropriately treated or monitored.

Conclusion: A systematic approach to assessment and management of physical health needs in people with severe mental illness is necessary. Suggestions for improvement include: healthy lifestyle encouragement; refer patients with metabolic syndrome to GP for treatment; optimization of current psychiatric treatment; monitor waist circumference, fasting lipids and glucose 4 times a year if patient has ≥ 3 criteria, or twice yearly if patient has 0–2 criteria; monitor BP monthly for all patients.