An analysis of NHS data has shed light on the “scandal” of why adults with severe mental illness are more likely to die 15 to 20 years younger than the general population.
The Rethink Mental Illness charity has revealed that adults under 75 with serious mental ill health – defined as those referred to specialist secondary mental health services – 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.
They are also 14.6 times as likely to die due to suicide, compared with those who were not referred. Overall, they are 4.8 times more likely to die of any cause before the age of 75 than the general population.
For some conditions, these health inequalities are the starkest to date. For working-age adults living with a mental illness, the number of deaths from cardiovascular disease and cancer are at their highest levels since records began, each with more than 24,000 deaths in the 2022-2024 reporting period, the charity calculated.
Cancer, cardiovascular disease, liver disease and respiratory disease accounted for more than half (56.5%) of deaths for 18- to 74-year-olds with severe mental health problems in England during this period. Cancer and cardiovascular disease each accounted for just under 19% of all deaths, respiratory disease 11%, and liver disease 8%. During the same period, suicide comprised 7% of these early deaths.
The report identifies a number of factors driving this excess mortality, including poverty, poor housing, higher rates of smoking, weight gain from medication, physical inactivity, and fragmented care. But the authors conclude that “diagnostic overshadowing” – where physical symptoms are wrongly attributed to mental illness – means potential illnesses are not always properly investigated and treated.
The findings come before the government’s independent review of mental health, autism and ADHD, which is expected to be published this week and recommend a more holistic approach to supporting patients with these conditions.
Mark Winstanley, the chief executive of Rethink, said: “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.
“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.”
Responding to the findings, Prof Subodh Dave, the president of the Royal College of Psychiatrists, said: “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.”
A Department of Health and Social Care spokesperson said: “People living with severe mental illness face stark health inequalities, and too many continue to experience poorer physical health outcomes.
“This government is taking immediate action to transform services for people with severe mental illness. We’re developing a new modern service framework to look at what action is needed to help people live healthier and longer lives through high-quality care, opening 100 new community mental health centres, and our mental health strategy will go further, outlining how we plan to build a more integrated system that responds earlier and reduces waiting times for support.”
• In the UK and Ireland, Samaritans can be contacted on freephone 116 123. In Canada, you can call or text the Suicide Crisis Helpline on 988. In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org
• This article was amended on 22 September 2026. The headline and opening paragraph were changed to better reflect the findings of the Rethink report, which was based on a new analysis of the causes of death of people under the age of 75 with severe mental health problems.
