Severe mental illness linked to ‘preventable’ physical disease death

More than 26,000 adults with severe mental illness die prematurely each year from preventable physical illnesses, according to a royal college.

The Royal College of Psychiatrists crunched the latest data from the Office for Health Improvement & Disparities, which showed that 120,273 adults in England with severe mental health conditions, including psychosis, post-traumatic stress disorder and schizophrenia, died before the age of 75 between 2018 and 2020.

Of these, the college has estimated 80,182 deaths (in other words two in three) were potentially preventable, or an average of 26,727 people each year.

‘Preventable’ deaths in this context include deaths from diseases such as cancer and heart disease, which could have been prevented with earlier detection and treatment or lifestyle changes.

While adults with severe mental illness are more likely to engage in unhealthy behaviours such as smoking and drinking alcohol excessively, they are also less likely to access screening and treatment for a range of reasons, including stigma associated with having a mental illness, the college pointed out.

While cancer is the leading cause of premature death among those with serious mental health conditions, it also significantly increases the risk of dying before the age of 75 across a range of physical health conditions. In all, according to the college’s analysis, adults were on average:

• 6.6 times more likely to die prematurely from respiratory disease
• 6.5 times more likely to die prematurely from liver disease
• 4.1 times more likely to die prematurely from cardiovascular disease
• 2.3 times more likely to die prematurely from cancer.

Equally worryingly, the mortality gap between those living with severe mental illness and the rest of the population was widening, the college concluded.

Over a three-year period, from 2015 to 2017, these adults were 4.6 times more likely to die before the age of 75 than those without a severe mental illness. This increased to 4.9 times in the following three years from 2018 to 2020. As of March 2023, there were 535,204 adults with a diagnosed severe mental illness in England, the college added.

The college is calling on the government to close the mortality gap and provide full annual health checks to everyone with a severe mental illness.

This, it has argued, should comprise blood pressure, blood glucose and blood lipids tests plus BMI weight, alcohol status and smoking assessments.

Dr Adrian James, president of the Royal College of Psychiatrists, said: “As a psychiatrist, I urge everyone who knows someone with severe mental illness to look out for them and ensure they receive professional support for both their physical and mental health problems.

“Having a severe mental illness shouldn’t be an early death sentence. We’re calling on the government to ensure everyone with severe mental illness receives an annual physical health check and to ensure reducing premature mortality is a major priority in the forthcoming Major Conditions Strategy.”