Severe Mental Illness Linked to 10 to 20 Year Life Expectancy Gap

People with a severe mental illness die 10 to 20 years earlier than the general population, according to recent findings from research efforts in Australia and England. An analysis of NHS data by the Rethink Mental Illness charity reveals that adults with severe mental health problems in England die 15 to 20 years earlier than the wider adult population. Similarly, research led by the University of Queensland found that individuals with severe mental illness in Australia die more than 10 years earlier than the general population.

Life Expectancy Gap for Individuals with Severe Mental Illness

In the Australian study, which analyzed hospital mortality data from about 255,000 patients in Queensland over a 14-year period, researchers observed a gender breakdown in the life expectancy gap: males with mental health disorders die 12 years earlier than the general population, while females die 10 years earlier. Lead author Mike Trott noted that while the mortality gap is improving overall—showing that people with severe mental illnesses are living longer than they were 14 years ago—the mortality rate for patients with psychoses such as schizophrenia has flatlined, indicating that the sickest patients are not benefiting from better care.

Preventable Physical Conditions Drive Excess Mortality

The research highlights that physical illness is the principal driver of excess mortality, with patients dying younger from preventable physical health conditions. According to the Xinhua report, patients with severe mental illness often require more complex care, and medication side effects such as weight gain combined with a reduction in physical activity can lead to poorer physical health.

Data from England analyzed by Rethink Mental Illness further details the increased risk of dying from specific physical diseases before the age of 75 for adults referred to specialist secondary mental health services. Overall, these individuals are 4.8 times more likely to die before the age of 75 than the general population. Specifically, they face the following increased risks of mortality from various conditions:

Severe Mental Illness Linked to 10 to 20 Year Life Expectancy Gap — Photo: UA.NEWS

Liver disease: 6.3 times higher risk
Respiratory illness: 6 times higher risk
Cardiovascular disease: 3.8 times higher risk
Cancer: 2.3 times higher risk
Suicide: 14.6 times higher risk

During the 2022–2024 reporting period in England, cancer, cardiovascular disease, liver disease, and respiratory disease accounted for more than half (56.5%) of all deaths for 18 to 74-year-olds with severe mental health problems. Cancer and cardiovascular disease each accounted for just under 19% of all deaths, respiratory disease accounted for 11%, liver disease for 8%, and suicide comprised 7% of these early deaths. Furthermore, the number of deaths from cancer and cardiovascular diseases among working-age adults with mental disorders exceeded 24,000 in each category during this period, marking the highest figures since records began.

Contributing Factors and Healthcare System Responses

The studies identify multiple compounding factors driving this excess mortality. Beyond medication side effects and physical inactivity, the reports point to poverty, poor housing, higher smoking rates, and fragmented care. Additionally, the English analysis highlights diagnostic overshadowing—situations where physical symptoms are mistakenly attributed to a patient’s mental state, leading to missed opportunities to properly examine and treat potential physical illnesses.

Medical leaders and organizations have called for systemic improvements to address these disparities. Prof Subodh Dave, president of the Royal College of Psychiatrists, stated that having a severe mental illness should not be an early death sentence, calling for regular physical health checks and smoking cessation programmes. Researchers emphasize that prioritizing physical health alongside mental health is essential in closing the mortality gap, particularly for individuals dealing with complex conditions and psychotic disorders.