What is already known about this topic• Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates.• No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. What this paper adds to existing knowledge• It appears feasible to use the HIP to profile and compare physical health-related risks in people with SMI across different international settings.• The HIP tool identified significant differences in areas of risk across the four countries. What are the implications for practice?• The HIP could be used to identify unique clusters of health promotion needs in different countries.• Use of HIP health checks may support implementation of individualized interventions.

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