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Serious mental illnesses cut life expectancy by 10-20 years

Serious mental illnesses reduce life expectancy by 10 to 20 years, a loss of years equivalent or worse than that for heavy smoking, research has suggested.

The average reduction in life expectancy for heavy smokers is eight to 10 years, according to researchers from Oxford University. But they note that mental health has not been the same public health priority as smoking.

Their study, published in the journal World Psychiatry, analysed previous research on mortality risk for a whole range of problems − mental health issues, drug and alcohol abuse, dementia, autistic spectrum disorders, learning disability and childhood behavioural disorders.

“People with serious mental illnesses may not access healthcare effectively”

Seena Fazel

The authors examined 20 research papers looking at 1.7 million people and over 250,000 deaths.

They found the average reduction in life expectancy for people with bipolar disorder was between nine and 20 years, it was 10 to 20 years for schizophrenia, between nine and 24 years for drug and alcohol abuse, and around seven to 11 years for recurrent depression.

In comparison, the loss of years among heavy smokers was eight to 10 years.

“We found that many mental health diagnoses are associated with a drop in life expectancy as great as that associated with smoking 20 or more cigarettes a day,” said Dr Seena Fazel of the department of psychiatry at Oxford University.

“There are likely to be many reasons for this,” he said. “High-risk behaviours are common in psychiatric patients, especially drug and alcohol abuse, and they are more likely to die by suicide.


Seena Fazel

“The stigma surrounding mental health may mean people aren’t treated as well for physical health problems when they do see a doctor,” he added.

“Many causes of mental health problems also have physical consequences and mental illness worsen the prognosis of a range of physical illnesses, especially heart disease, diabetes and cancer.

“Unfortunately, people with serious mental illnesses may not access healthcare effectively,” said Dr Fazel. “All of this can be changed.

“That means making sure people have straightforward access to healthcare, and appropriate jobs and meaningful daytime activities. It’ll be challenging, but it can be done.”

He said: “There are effective ways to target smoking, and with political will and funding, rates of smoking-related deaths have started to decline. We now need a similar effort in mental health.”

“Mental illness is just as threatening to life expectancy as other public health threats such as smoking”

John Williams

Dr John Williams, head of neuroscience and mental health at the Wellcome Trust, which funded the study, said: “People with mental health problems are among the most vulnerable in society.

“This work emphasises how crucial it is that they have access to appropriate healthcare and advice, which is not always the case,” he said.

“We now have strong evidence that mental illness is just as threatening to life expectancy as other public health threats such as smoking,” he added.

Geoff Heyes, policy and campaigns manager at the charity Mind, said: “We urgently need to see mental health services given as much importance as physical health, and much better integration of mental and physical health services, so that people are treated as a whole and taken seriously.”

Readers' comments (5)

  • Why do we persist in stigmatising mental health problems?

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  • No full reference, then you send us to a web page listing 12 years worth of journals and no search facility? Seriously NT?

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  • So, I managed to locate and read the paper. I'm surprised that there is no mention in the analysis of the role of neuroleptics in metabolic syndrome (i.e. obesity, high blood lipids, high glucose) or of lack of exercise and poor nutrition. These are deadly enough in the general population, positively lethal if you are on neuroleptics.
    My most dispiriting experiences have been seeing how little encouragement is given to promoting exercise and good nutrition on the wards (chips, spuds, puddings groaning in sugar and other refined carbs, biscuits, fruit juice, crap). No effort at controlling tobacco use, apart from restricted hours leading to binge smoking. I dispensed neuroleptics with one hand and smoking materials with the other - appalling.
    If you omit to dispense someone's meds, you're in trouble. Feed them nutritional poisons, tobacco and a sedentary lifestyle and no-one notices. Our practice of 'care' is what is truly insane in mental health.

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  • It is refreshing to hear your self critical views. Tallied with the 1st comment about stigmatising mental health the answer becomes clear - get out of super mental health trusts and into single organisations providing care across a whole spectrum of need for the whole of society. keeping mental health separate is the problem. Mental health professionals therefore fuel the stigma and don't keep themselves tied into a socially driven model of care.

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  • @Anonymous | 27-May-2014 2:50 pm

    single groups of general practitioners commissioning care from a whole spectrum of providers for the whole of their patient lists? mental health professionals as tied into this "socially driven" model of care as chiropodists, oncologists or physiotherapists?

    careful what you wish for, it might just happen!

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