Severe Mental Illness Cuts Life Expectancy by 15 to 20 Years, Analysis Finds

People being treated for severe mental illness, conditions such as schizophrenia, bipolar disorder and severe depression, die 15 to 20 years earlier than the general population. Researchers have documented that gap for more than a decade. What a new analysis of NHS data adds is a breakdown of exactly which diseases are driving it, and the answer is not the psychiatric diagnosis itself.

The analysis comes from Rethink Mental Illness, a UK charity, working from NHS data covering 2022 through 2024. It was first reported by The Guardian on September 20. The charity found that adults under 75 who had been referred to specialist secondary mental health services were 4.8 times more likely to die before that age than adults who had not been referred.

The diseases doing the damage

Cardiovascular disease and cancer are the two biggest killers in the group Rethink studied. Adults under 75 in specialist mental health services were 3.8 times more likely to die of cardiovascular disease and 2.3 times more likely to die of cancer than adults who were not in those services. Liver disease showed the widest relative gap, at 6.3 times, followed by respiratory illness at 6 times.

Cancer, cardiovascular disease, liver disease and respiratory disease together accounted for 56.5% of deaths among 18 to 74 year olds with severe mental health problems in England over the same period. Cancer and cardiovascular disease each made up just under 19% of those deaths, respiratory disease 11%, and liver disease 8%. Suicide accounted for 7% of the early deaths in this group, itself 14.6 times more common than among people not referred to specialist services, according to gov.uk figures the charity cited. For working-age adults living with mental illness, deaths from cardiovascular disease and cancer reached their highest levels since records began, more than 24,000 each in the 2022-to-2024 period.

Why the physical illness gets missed

The report names several drivers behind the excess deaths: poverty, poor housing, higher smoking rates, weight gain tied to psychiatric medication, low physical activity and fragmented care between mental health and general medical services. None of those on its own is a new finding.

The mechanism the report's authors single out is what clinicians call diagnostic overshadowing. A physical symptom, chest pain, fatigue, unexplained weight loss, gets read as part of the psychiatric condition instead of investigated on its own. It works the way a limp might get waved off as clumsiness in a patient already flagged as unsteady, so the actual injury underneath never gets an X-ray.

“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.”

Prof Subodh Dave, president of the Royal College of Psychiatrists, called the pattern unacceptable and pointed to specific fixes already known to work.

“Having a severe mental illness shouldn't be an early death sentence. This stark inequality is unacceptable. People with severe mental illness deserve the same opportunity to live long, healthy lives as everyone else. We know that evidence-based solutions to close this gap exist, from smoking cessation to routine physical health checks. But what is lacking is concerted action to prevent these premature deaths.”

What officials say happens next

A Department of Health and Social Care spokesperson said the government is developing a new modern service framework and opening 100 community mental health centers, alongside a broader mental health strategy meant to catch physical problems earlier and cut waiting times. The findings landed days before an independent government review of mental health, autism and ADHD services, expected within the week, which is reportedly set to recommend a more integrated approach to patient care.

The 15-to-20-year estimate is not new. A 2021 paper in the Annals of General Psychiatry by researchers Andrea Fiorillo and Norman Sartorius put the same gap at 10 to 25 years and called it a public health scandal, tracing it to the same physical conditions Rethink's newer figures now isolate by disease. What changed between then and now is precision, not the underlying problem: this dataset breaks the gap down by specific cause and by year in a way the earlier estimate did not, but the gap itself has not closed.