Adults with severe mental illness in England die 15 to 20 years earlier than the general population, largely from preventable physical conditions such as cardiovascular disease, cancer, respiratory illness, and liver disease, according to an analysis of NHS data released by the charity Rethink Mental Illness.
The health inequalities facing people living with severe mental health problems remain stark, with new figures showing that adults under 75 who are referred to specialist secondary mental health services are nearly five times more likely to die prematurely than their peers according to research analyzed by the charity. This early mortality gap is driven heavily by chronic physical ailments that often go unaddressed despite frequent contact with healthcare providers.
The Leading Physical Drivers of Early Mortality
Data covering the 2022 to 2024 reporting period reveals that cancer, cardiovascular disease, respiratory disease, and liver disease accounted for more than half—specifically 56.5%—of all deaths among working-age adults aged 18 to 74 with severe mental illness in England. Cancer and cardiovascular disease each accounted for just under 19% of those deaths, while respiratory disease contributed 11% and liver disease represented 8% as detailed in regional reporting of the findings. Suicide accounted for 7% of early deaths within this group.
For working-age adults living with mental illness, fatalities from cardiovascular disease and cancer reached their highest levels since records began during this same reporting window, with each category exceeding 24,000 deaths the organization calculated. When broken down by specific diagnoses, adults under 75 with serious mental health problems face disproportionately high risks: they are 6.3 times as likely to die from liver disease, 6 times more likely from respiratory illness, 3.8 times more likely from cardiovascular disease, and 2.3 times more likely from cancer compared to those not referred to specialist care.
Systemic Barriers and Diagnostic Overshadowing
The report points to a cluster of compounding social and clinical factors fueling this excess mortality. Poverty, poor housing conditions, higher smoking rates, weight gain induced by medication, physical inactivity, and fragmented healthcare services all play major roles in degrading physical health outcomes according to the study’s authors.
Clinicians and advocates emphasize that a primary hurdle is diagnostic overshadowing
, a phenomenon where physical symptoms in patients are mistakenly attributed entirely to their existing mental health state, causing providers to miss critical windows for proper medical investigation and treatment as highlighted by the charity’s findings.
“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
Smoking Cessation and Effective Interventions
Because smoking heavily drives cardiovascular and cancer mortality among individuals with severe mental illness—with roughly 40% of this population smoking tobacco—identifying effective cessation treatments remains paramount a systematic review and network meta-analysis noted.
Policy Responses and Next Steps
Prof Subodh Dave, president of the Royal College of Psychiatrists, noted that solutions ranging from smoking cessation programs to routine physical health checks are well known, but what is lacking is concerted action to prevent these premature deaths
in a published statement.
These structural adjustments coincide with an independent review of mental health, autism, and ADHD scheduled for publication.