Mental health conditions are linked to shorter average life expectancies. Cardiometabolic risk in particular is amplified, although the mortality and morbidity derive from a range of different conditions. This talk will discuss the relationships between severe mental illness and physical health. It will also summarise research from the NIHR-funded IMPaCT programme. IMPaCT included a prospective cohort study in first episode psychosis and an RCT to determine the effectiveness and cost-effectiveness of a psychosocial health promotion intervention delivered as part of routine care by the patient’s own care co-ordinator in improving cardiometabolic risk at one year in people with established psychosis. We also examined vitamin D levels in view of the links to cardiometabolic risk and bone health. Overall, there are links between psychosis and a variety of physical health conditions. To reduce cardiometabolic risk once established is challenging. Maintaining health in early psychosis is thus a priority.