Adults with severe mental illness die nearly five times more frequently from serious physical diseases before age 75 than the general population, according to NHS data analyzed by the Rethink Mental Illness charity. This mortality gap means individuals with severe mental health problems face a life expectancy shortened by 15 to 20 years, driven largely by preventable conditions like cardiovascular disease, cancer, liver disease, and respiratory illness.
Mortality Rates and Leading Causes of Early Death in Severe Mental Illness
The analysis reveals stark health inequalities across specific physical health conditions for adults under 75 referred to specialist secondary mental health services. According to Rethink calculations, this demographic is 6.3 times as likely to die from liver disease and 6 times more likely to succumb to respiratory illness compared to the wider public. Cardiovascular disease deaths occur 3.8 times more often, while cancer mortality is 2.3 times higher. Additionally, suicide accounts for a 14.6-fold increase in early deaths within this group.
For working-age adults, fatalities from cardiovascular disease and cancer reached historic highs during the 2022-2024 reporting period, with more than 24,000 deaths recorded for each condition. Overall, cancer, cardiovascular disease, liver disease, and respiratory disease accounted for 56.5% of deaths among 18-to-74-year-olds with severe mental health problems in England during this window. Cancer and cardiovascular disease each represented just under 19% of all deaths, respiratory disease comprised 11%, and liver disease accounted for 8%, while suicide made up 7%.
Drivers Behind the Health Gap and Diagnostic Overshadowing
Multiple systemic and lifestyle factors drive this excess mortality, including poverty, poor housing, higher smoking rates, physical inactivity, and weight gain induced by medication. However, the report highlights diagnostic overshadowing as a primary barrier to care. This phenomenon occurs when clinicians wrongly attribute physical symptoms directly to a patient’s mental illness, leaving potential physical ailments uninvestigated and untreated.
Mark Winstanley, chief executive of Rethink, stated: “It is a scandal that people living with severe mental health problems are so much more likely than the rest of the population to die from often preventable physical health conditions.” He added that because many patients maintain frequent contact with health services throughout their lives, opportunities to identify and treat physical health problems are clearly being missed.
Did you know? More than half of all deaths among working-age adults with severe mental health problems in England are attributed to just four physical conditions: cancer, cardiovascular disease, liver disease, and respiratory illness, according to charity calculations.
Official Responses and Forthcoming Government Strategy
The findings precede an independent review of mental health, autism, and ADHD expected to be published by the government, which will recommend a holistic approach to patient support. Prof Subodh Dave, president of the Royal College of Psychiatrists, responded to the findings by noting that having a severe mental illness should not serve as 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,” Dave stated.
A Department of Health and Social Care spokesperson acknowledged the stark inequalities, stating that the government is taking immediate action to transform services. Plans include a modern service framework, the opening of 100 new community mental health centres, and a new mental health strategy designed to build an integrated system that responds earlier and reduces waiting times.
Frequently Asked Questions
How much shorter is the life expectancy for adults with severe mental illness?
People with severe mental health problems die 15 to 20 years earlier than the wider adult population, largely due to preventable physical conditions, according to the Rethink Mental Illness analysis of NHS data.
What are the primary physical causes of early death in this group?
The leading physical causes include cancer, cardiovascular disease, liver disease, and respiratory disease. Together, these four conditions account for 56.5% of deaths for individuals aged 18 to 74 with severe mental health problems in England.
What is diagnostic overshadowing?
Diagnostic overshadowing is a process where clinicians wrongly attribute a patient’s physical symptoms to their pre-existing mental illness, resulting in potential physical conditions going uninvestigated and untreated.
Where can individuals seek immediate mental health support?
In the UK and Ireland, Samaritans can be reached on freephone 116 123. In the US and Canada, the Suicide Crisis Helpline is available by calling or texting 988. In Australia, Lifeline can be reached at 13 11 14.
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