The Mortality Gap: Severe Mental Illness and the Crisis of Premature Death from Preventable Diseases

Adults living with severe mental illness face a significantly elevated risk of premature death, dying 15 to 20 years earlier than the general population, often due to preventable physical health conditions.

An analysis of NHS data by the charity Rethink Mental Illness reveals that individuals under the age of 75 with severe mental health problems are nearly five times more likely to die from serious physical illnesses than their peers. The study highlights stark disparities, showing that those referred to specialist secondary mental health services are 6.3 times more likely to die from liver disease, 6 times more likely to succumb to respiratory illness, 3.8 times more likely to die from cardiovascular disease, and 2.3 times more likely to die from cancer. Additionally, they are 14.6 times more likely to die by suicide, leading to an overall mortality rate 4.8 times higher than the general population before age 75.

The report underscores that for working-age adults, deaths from cardiovascular disease and cancer have reached their highest recorded levels, with more than 24,000 deaths for each condition during the 2022–2024 period. Together, cancer, cardiovascular disease, liver disease, and respiratory illness accounted for over half (56.5%) of all deaths among individuals aged 18 to 74 with severe mental health issues in England. Cancer and cardiovascular disease each represented just under 19% of these deaths, followed by respiratory disease at 11% and liver disease at 8%, while suicide accounted for 7%.

Researchers attribute these alarming trends to a combination of socioeconomic factors, including poverty, poor housing, higher rates of smoking, medication-related weight gain, physical inactivity, and fragmented healthcare services. Crucially, the phenomenon of “diagnostic overshadowing”—where physical symptoms are mistakenly dismissed as manifestations of mental illness—further delays proper diagnosis and treatment.

Mark Winstanley, Chief Executive of Rethink Mental Illness, described the situation as a national scandal, emphasizing that frequent contact with healthcare services presents critical missed opportunities for early physical health intervention. He advocated for a new cross-government mental health strategy that prioritizes routine physical health checks, improves access to mental-health informed care, and strengthens peer support to reduce these health inequalities.

Professor Subodh Dave, President of the Royal College of Psychiatrists, stated that severe mental illness should not equate to an early death sentence. “We know that evidence-based solutions to close this gap exist—from smoking cessation to routine physical health checks—but what is lacking is concerted action to prevent these premature deaths,” he remarked.

A Department of Health and Social Care spokesperson acknowledged the stark health inequalities, announcing that the government is developing a new modern service framework, planning to open 100 new community mental health centres, and integrating physical health checks into mental health strategies to promote longer, healthier lives.

In the UK and Ireland, Samaritans can be contacted on freephone 116 123. In Canada, you can call or text the Suicide Crisis Helpline on 988. In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org.

Source link