People living with a severe mental illness die 15 to 20 years earlier than average, mainly because of preventable physical health problems and not their mental illness itself. 

The main reasons behind the life expectancy gap 

Higher risk of physical health conditions 

People with severe mental illness are more likely to develop serious illnesses such as: 

• Cardiovascular disease
• Diabetes
• Respiratory diseases (including asthma and COPD)
• Coronary heart disease
• Stroke
• Heart failure
• Liver disease
• Cancer 

These conditions often appear earlier and can occur together, making health management harder. 

Lifestyle and health risk factors 

Many people living with severe mental illness also face extra health issues and an increased risk of chronic diseases from: 

• Smoking
• Low physical activity
• Poor diet
• Emotional eating
• Alcohol misuse
• Drug misuse
• Weight gain and obesity 
  
  

Smoking: the biggest contributor 

Smoking raises the risk of heart disease, cancer, and diabetes, and 40% of people living with severe mental illness smoke, compared to 13% of adults overall. Smoking is also often heavier and more frequent, and about half of deaths of people in this group are linked to it.  

Why are people living with severe mental illness more likely to experience poor health, and engage in habits that can contribute towards poor health? 

There are a range of factors that contribute towards this picture. People living with severe mental illness are both more likely - compared to the general population to experience factors that contribute towards poor health (such as social inequalities), and experience circumstances specifically relating to living with a mental illness that impact their health also.  

Mental health-related factors 

Some people with severe mental illness state that they feel compelled to using smoking, alcohol, drugs or food in response to distress and to manage the symptoms of their illness or side effects of medication. 

Some antipsychotic medicines can cause rapid weight gain, leading to type 2 diabetes, heart disease, and obesity-related illnesses. 

Weight gain and lethargy caused by the side effects of medication can also contribute can also make it challenging to engage in physical activity. 

People living with severe mental illness often struggle to get the care they need because physical symptoms may be dismissed or their mental health needs are prioritised over physical health.  

Issues also appear due to physical and mental health services being separated, and the care offered being fragmented and not person-centred: 

• Physical and mental health services are separated
• Care is fragmented, not person-centred
• Physical symptoms may be dismissed
• Mental health needs are prioritised over physical health
  
  

Wider social inequalities 

Many people living with severe mental illness will face the added stressors of poverty, poor housing, stigma and discrimination, and social exclusion.  

And we know that these challenges make it harder to access healthcare, eat well, stay active, and maintain good health. 

The change we want to see 

Rethink Mental Illness is calling for a national, preventative, integrated approach to physical and mental healthcare. We need to ensure that everyone living with a mental illness receives annual Physical Health Checks and appropriate follow-up support.  

Mental health-informed smoking cessation, physical activity,  and weight management are central to this approach - backed by peer support and appropriate workforce training.  We need a mental health system with long-term investment, so that people with severe mental illness no longer die 15 to 20 years earlier than the rest of the population.