A haemato-neuro-renal diagnostic challenge in advanced HIV: multiple opportunistic infections including novel Mycobacterium chelonae pyelonephritis and HIV-associated neurocognitive disorder with myel

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. 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.