Adults living with severe mental illness in England die 15 to 20 years earlier than the wider population, largely driven by preventable physical health conditions and systemic gaps in care, according to an NHS data analysis published by the charity Rethink Mental Illness. The findings reveal that patients under 75 referred to specialist secondary mental health services are 4.8 times more likely to die before the age of 75 compared to the general population.
Mortality Rates and Leading Physical Disease Risks
According to the Rethink Mental Illness report, individuals with severe mental ill health face starkly elevated risks of dying from major physical illnesses before turning 75. When looking at patients not referred to secondary services, the data reveals that these adults face a 6.3-fold increased risk of dying from liver disease, a 6-fold higher chance of mortality from respiratory illness, a 3.8-fold greater likelihood of death due to cardiovascular disease, and a 2.3 times higher risk of dying from cancer. Additionally, suicide accounts for a significant portion of excess mortality, with patients facing a 14.6-fold increase in suicide risk.
Data covering the 2022-2024 reporting period shows that cancer, cardiovascular disease, liver disease, and respiratory disease combined accounted for more than half—specifically 56.5%—of all deaths among 18 to 74 year olds with severe mental health problems in England. Cancer and cardiovascular disease each represented just under 19% of all deaths during this timeframe, while respiratory illness caused 11% and liver disease accounted for 8%. Suicide comprised 7% of these early deaths. Furthermore, deaths from cardiovascular disease and cancer among working-age adults with mental illness reached their highest levels since records began, with more than 24,000 fatalities recorded for each condition during the 2022-2024 period.
Drivers of Health Inequality and Diagnostic Overshadowing
The analysis identifies multiple factors fueling excess mortality, including poverty, poor housing, elevated smoking rates, weight gain induced by medication, physical inactivity, and fragmented care systems. However, the report highlights a critical clinical barrier known as “diagnostic overshadowing,” a phenomenon where physical symptoms are wrongly attributed to mental illness. Consequently, potential illnesses often fail to receive proper medical investigation and treatment.
Mark Winstanley, chief executive of Rethink, described the findings as a scandal, noting that because many patients maintain frequent contact with health services throughout their lives, opportunities to identify and treat physical health problems are frequently missed. Winstanley emphasized that these early deaths are not inevitable and urged that the new cross-government mental health strategy must prioritize physical health checks, improved access to mental-health informed interventions, and bolstered peer support.
Response From Medical Leaders and Government
Responding to the findings, Prof Subodh Dave, president of the Royal College of Psychiatrists, stated that having a severe mental illness shouldn’t be an early death sentence. Dave noted that while evidence-based solutions such as smoking cessation and routine physical health checks exist to close this gap, concerted action to prevent premature deaths remains lacking.
Addressing the issue, a representative for the Department of Health and Social Care conceded that severe mental illness often coincides with profound health disparities, leaving numerous patients vulnerable to substandard physical health outcomes. The government is taking immediate action to transform services by developing a new modern service framework aimed at helping people live healthier and longer lives through high-quality care, alongside opening 100 new community mental he