Adults living with severe mental illness die 15 to 20 years earlier than the general population, primarily driven by preventable physical conditions like cancer and cardiovascular disease. Recent data from the United Kingdom highlight persistent health inequalities, prompting calls for routine physical health checks and integrated care.
People diagnosed with severe mental health problems face stark health disparities that shorten their lifespans significantly compared to the wider population. An analysis of NHS data by the Rethink Mental Illness charity reveals that individuals under 75 with serious mental ill health are nearly five times more likely to die from serious physical diseases than their peers.
Preventable Physical Diseases Drive Excess Mortality
The primary driver behind this reduced life expectancy is not the mental illness itself, but unmanaged physical health conditions. According to the Rethink calculations, working-age adults under 75 who rely on specialist secondary mental health services face drastically elevated risks of specific fatal illnesses. 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 as likely from cancer. In England alone during the 2022-2024 reporting period, cancer, cardiovascular disease, liver disease, and respiratory disease accounted for more than half (56.5%) of all deaths for individuals aged 18 to 74 with severe mental health problems.
Researchers point to a cluster of contributing factors, including poverty, poor housing, higher rates of smoking, and physical inactivity. Furthermore, medication side effects such as weight gain contribute significantly to poorer physical health outcomes. Compounding these physical vulnerabilities is a phenomenon known as diagnostic overshadowing
, where physical symptoms are incorrectly attributed solely to a patient’s existing mental illness, leading to delayed or missed diagnoses.
Smoking Cessation Interventions and Pharmacological Options
Tobacco use remains a major contributor to the high rates of cardiovascular disease and cancer observed in this population. Around 40% of people living with severe mental illness smoke tobacco, frequently starting at a younger age and smoking more heavily than the general public, according to existing public health data. While stopping smoking is beneficial for physical health, research demonstrates it is also associated with reductions in depression, anxiety, and stress.
A systematic review and network meta-analysis evaluated the effectiveness of various smoking cessation aids specifically for adults with conditions like schizophrenia, bipolar disorder, and post-traumatic stress disorder.
Calls for Concerted Action and Systemic Reform
Medical professionals and advocacy groups emphasize that these premature deaths are preventable. Mark Winstanley, chief executive of Rethink Mental Illness, stressed that opportunities to identify physical ailments are frequently missed despite patients having frequent contact with health services throughout their lives.
“These early deaths are not inevitable. The new cross-government mental health strategy … must prioritise physical health checks, improve access to mental-health informed interventions and bolster peer support, if it wants to reduce these terrible health inequalities.”
Mark Winstanley, Chief Executive of Rethink, via The Guardian
Prof Subodh Dave, president of the Royal College of Psychiatrists, echoed these concerns, stating that evidence-based solutions such as routine physical health checks and smoking cessation programs already exist, but what remains lacking is coordinated action to implement them across health systems.
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