Adults living with severe mental illness in England die 15 to 20 years earlier than the general population, largely from preventable physical diseases, according to an analysis of NHS data by the charity Rethink Mental Illness.
Stark Mortality Gap and Preventable Physical Health Conditions
Adults under 75 with serious mental health problems—defined as individuals referred to specialist secondary mental health services—face a dramatically elevated risk of premature mortality. Overall, they are 4.8 times more likely to die before the age of 75 than the wider adult population, driven largely by conditions that frequently go unmanaged or undetected.
According to calculations from Rethink Mental Illness, the excess mortality is heavily concentrated in four major physical disease categories. During the 2022–2024 reporting period, cancer, cardiovascular disease, respiratory illness, and liver disease accounted for 56.5% of all deaths among 18-to-74-year-olds with severe mental health problems in England.
- Liver disease: Patients are 6.3 times as likely to die compared to non-referred peers.
- Respiratory illness: Patients face a 6 times higher risk of death.
- Cardiovascular disease: Patients are 3.8 times as likely to die.
- Cancer: Patients face a 2.3 times higher risk of death.
- Suicide: Mortality from suicide is 14.6 times higher, comprising 7% of early deaths in this group.
Record Highs in Working-Age Deaths
For the 2022–2024 reporting window, deaths from cardiovascular disease and cancer each exceeded 24,000 among working-age adults living with mental disorders in England, which the charity calculates are the highest figures since records began.
Independent research from Australia mirrors parts of these systemic gaps while highlighting specific trajectories among psychiatric patients. A study led by the University of Queensland and published in Lancet Regional Health — Western Pacific analyzed hospital mortality data from about 255,000 patients across Queensland over a 14-year period.
“mortality rates for patients with psychoses such as schizophrenia had ‘flatlined,’ highlighting that the sickest patients were not benefiting from better care”
Mike Trott, Faculty of Health, Medicine and Behavioral Sciences, UQ
Drivers of Inequality: Diagnostic Overshadowing and Lifestyle Factors
The reports cite poverty, poor housing conditions, higher smoking rates, insufficient physical activity, and fragmented healthcare as primary systemic contributors.
Furthermore, medication side effects such as weight gain and reduction in physical activity can lead to poorer physical health. Compounding these medication side effects is a phenomenon known as diagnostic overshadowing
, wherein clinicians mistakenly attribute genuine physical symptoms to a patient’s existing mental state, leading to delayed investigations and untreated illnesses.
“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. Given that many are in frequent contact with health services throughout their lives, it is clear that opportunities to identify and treat physical health problems are being missed.”
Mark Winstanley, chief executive of Rethink
International Context and Systemic Reform Calls
The Australian data reveals a parallel demographic split, with males with mental health disorders dying 12 years earlier and females dying 10 years earlier than the general population. Trott emphasized that physical illness remains the principal driver of excess mortality, with complex care requirements often exacerbating physical decline.
In the UK, the findings arrived ahead of an expected government review of mental health, autism, and ADHD. Medical leaders argue that solutions are already established but lack concerted action.
“Having a severe mental illness shouldn’t be an early death sentence. This stark inequality is unacceptable. People with severe mental illness deserve the same opportunity to live long, healthy lives as everyone else. 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.”
Prof Subodh Dave, president of the Royal College of Psychiatrists
Government and Healthcare Responses
Responding to the data, a Department of Health and Social Care spokesperson acknowledged the stark health inequalities facing patients with severe mental illness and pointed to ongoing transformations in service delivery. Officials noted the development of a modern service framework aimed at improving long-term health outcomes, alongside the opening of 100 new community mental health centres designed to integrate physical and mental healthcare systems.
Advocacy groups maintain that future cross-government strategies must prioritise routine physical health checks, enhance access to mental-health-informed interventions, and bolster peer support networks to close the mortality gap permanently.