People With Severe Mental Illness Are Dying 15 to 20 Years Younger, and It's Not Suicide Killing Them

Adults with severe mental illness are dying 15 to 20 years earlier than the general population, according to an analysis of NHS data by the charity Rethink Mental Illness reported by The Guardian. The cause isn't what most people assume.

Rethink's numbers, based on English hospital records, show adults under 75 who've been referred to specialist mental health services are 4.8 times more likely to die before that age than the general population. Break it down by disease: 6.3 times more likely to die of liver disease, 6 times more likely from respiratory illness, 3.8 times more likely from cardiovascular disease, 2.3 times more likely from cancer. Suicide risk is 14.6 times higher, but suicide made up just 7% of early deaths in this group during the 2022-2024 reporting period. Cancer and cardiovascular disease each accounted for nearly 19%, and each killed more than 24,000 working-age adults with mental illness in that window, the highest totals Rethink says it has on record.

A companion survey from King's Health Partners, the Maudsley Charity and the Policy Institute at King's College London, covered by Archyde, found the public has no idea. Polling 2,000 UK adults, researchers found only 1 in 9 correctly estimated the size of the mortality gap. The average guess was seven years. Half the people surveyed assumed early deaths among patients with schizophrenia, bipolar disorder or psychosis were mostly caused by suicide or substance abuse. The data says otherwise: it's overwhelmingly heart and lung disease.

Chronic psychiatric stress drives inflammation, raises blood pressure, and promotes insulin resistance, according to the King's Health Partners research. Patients on antipsychotic medication often gain weight and become less active. Add higher smoking rates and worse access to routine screening, and the physical toll compounds. Professor Matthew Hotopf CBE, Deputy Executive Director of King's Health Partners, has pointed to the disconnect between cardiology and psychiatry as part of the problem. Cardiology clinics rarely screen for depression, and psychiatric services routinely skip basic checks on blood pressure, glucose and cholesterol.

Rethink's report calls this "diagnostic overshadowing," meaning a patient's physical symptoms get chalked up to their mental illness and never properly investigated. Rethink chief executive Mark Winstanley called the pattern a scandal, telling The Guardian that people with severe mental illness are in frequent contact with health services throughout their lives, which makes the missed diagnoses harder to excuse. Subodh Dave, president of the Royal College of Psychiatrists, called for systemic fixes including smoking cessation programs and regular physical health checks, according to coverage picked up by ua.news, which largely repeated The Guardian's reporting rather than adding independent findings.

This isn't just a UK problem. A separate study out of the University of Queensland, published in Lancet Regional Health-Western Pacific and covered by Medical Xpress, tracked roughly 255,000 hospital patients in Queensland over 14 years. Lead author Dr. Mike Trott found men with severe mental illness die 12 years earlier than the general population and women die 10 years earlier. The gap has narrowed over that period, which Trott called encouraging. But mortality for patients with psychotic disorders like schizophrenia has flatlined, meaning the sickest patients aren't benefiting from whatever improvements are helping everyone else. Trott's team concluded physical illness, not suicide or overdose, is the "principal driver" of the excess deaths, echoing the UK findings almost exactly.

There's a fair question buried in all this. Some of the excess mortality is clearly tied to individual behavior, smoking rates, diet, physical inactivity, factors patients and their families bear some responsibility for, not just the healthcare system. Charities pushing for a "structural overhaul" and a "cross-government strategy" can slide into language that sounds like a blank check for more spending without a clear mechanism for accountability. That's a legitimate concern anyone skeptical of open-ended government promises should raise.

But the specific asks in these reports aren't vague. They're concrete and measurable: run physical health checks, monitor blood pressure and cholesterol in psychiatric patients, screen for depression in cardiology clinics, treat a persistent cough or chest pain as a real symptom instead of a mental health side effect. Those are narrow, auditable fixes, not a blank check.

The Guardian's report notes it was published ahead of an independent UK government review of mental health, autism and ADHD care, which is expected to recommend a more integrated approach to physical and mental health treatment. Whether that review produces funded, measurable changes, or another round of strategy documents with no teeth, is the open question. Rethink's data will still be there next year to check the answer against.