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An analysis of NHS data has highlighted a substantial gap in life expectancy between people with severe mental illness and the wider adult population, with preventable physical health problems accounting for much of the difference.
Rethink Mental Illness found that adults with severe mental health problems die 15 to 20 years earlier on average. The analysis describes severe mental illness as involving people referred to specialist secondary mental health services.
The scale of the difference
Among adults under 75, people with serious mental ill health were 4.8 times more likely to die than people who had not been referred to specialist mental health services.
The risk varied by cause of death. The analysis found that this group was:
- 6.3 times as likely to die from liver disease
- 6 times as likely to die from respiratory illness
- 3.8 times as likely to die from cardiovascular disease
- 2.3 times as likely to die from cancer
- 14.6 times as likely to die by suicide
These figures describe differences between groups. They do not show that mental illness alone causes any individual death. Rethink identified a combination of factors linked to the inequality, including poverty, poor housing, higher smoking rates, weight gain associated with medication, physical inactivity and fragmented care.
Physical illness makes up most early deaths
In England, cancer, cardiovascular disease, liver disease and respiratory disease together accounted for 56.5% of deaths among 18- to 74-year-olds with severe mental health problems during the 2022–2024 reporting period.
Cancer and cardiovascular disease each made up just under 19% of deaths in this group. Respiratory disease accounted for 11%, liver disease for 8% and suicide for 7%.
Rethink’s calculations also found that deaths from cardiovascular disease and cancer among working-age adults living with a mental illness were each at their highest recorded levels, with more than 24,000 deaths in each category during the period.
Why diagnosis and prevention matter
The report’s authors warned that diagnostic overshadowing can contribute to poorer outcomes. This happens when physical symptoms are incorrectly assumed to be part of a person’s mental illness, meaning that possible physical conditions may not be investigated or treated promptly.
Mark Winstanley, chief executive of Rethink Mental Illness, said early deaths were not inevitable. He called for physical health checks, better access to mental-health-informed interventions and stronger peer support.
Prof Subodh Dave, president of the Royal College of Psychiatrists, said people with severe mental illness should have the same opportunity to live long, healthy lives as anyone else. He pointed to smoking cessation and routine physical health checks as evidence-based measures.
A move toward more integrated care
The government says it is developing a new modern service framework and plans to open 100 new community mental health centres. Its forthcoming mental health strategy is expected to set out plans for a more integrated system that responds earlier and reduces waiting times for support.
A Department of Health and Social Care spokesperson acknowledged that people living with severe mental illness face stark health inequalities and poorer physical health outcomes.
The findings are based on Rethink Mental Illness’s analysis and calculations of NHS data. The report identifies several contributing factors rather than a single explanation, underlining why mental and physical healthcare need to be considered together.
AI tools were used to assist with the preparation of this article.
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