Adults living with severe mental illness face stark health inequalities, dying 15 to 20 years earlier than the general population largely due to preventable physical conditions, new analysis reveals. Research shows that people with serious mental health problems referred to specialist secondary services are nearly five times more likely to die before age 75 than their peers, with cancer, cardiovascular disease, liver disease and respiratory illness accounting for the majority of these premature deaths.
The findings emerge from analysis of the latest NHS England adult mental health and wellbeing profile, updated on 2 September 2026, which includes fresh mortality data for the 2022-2024 reporting period across England, regions, integrated care boards and local authorities.
How much higher is mortality among people with severe mental illness?
Adults under 75 with serious mental health problems are 6.3 times as likely to die from liver disease compared with the general population, 6 times more likely to die from respiratory illness, 3.8 times more likely from cardiovascular disease and 2.3 times as likely from cancer. Overall, they face a 4.8 times greater risk of dying before age 75 than those without such conditions.
For working-age adults living with mental illness, the scale of the crisis is intensifying. The number of deaths from cardiovascular disease and cancer have reached their highest levels since records began, with each condition accounting for more than 24,000 deaths during the 2022-2024 period.
Which conditions account for most early deaths?
Cancer and cardiovascular disease each accounted for just under 19% of all deaths among 18 to 74 year olds with severe mental health problems during 2022-2024, while respiratory disease represented 11% and liver disease 8%. Together, these four conditions accounted for more than half (56.5%) of all early deaths in this population. Suicide comprised 7% of these premature deaths, with a separate NHS England publication on suicide in people with severe mental health problems also released on 2 September 2026, covering data from 2015-2017 through 2022-2024 across England and nine statistical regions.
What factors drive this excess mortality?
Multiple interconnected factors contribute to the premature deaths, including poverty, poor housing, higher rates of smoking, weight gain from psychiatric medication, and physical inactivity. Fragmented care systems that fail to coordinate mental and physical health support also play a significant role. However, a particularly troubling mechanism identified in the research is
diagnostic overshadowing– the practice of wrongly attributing physical symptoms to mental illness – which means potential illnesses are not always properly investigated and treated.
This pattern reflects broader trends in UK health. The UK has experienced the sharpest drop in healthy life expectancy among wealthy nations, driven by poverty, obesity and other preventable factors, indicating that health inequalities extend across multiple vulnerable populations.
What do health leaders say about these findings?
Mark Winstanley, chief executive of Rethink, the mental health charity that conducted the analysis, described the situation as unacceptable.
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.He emphasised that many people with severe mental illness are in frequent contact with health services throughout their lives, meaning opportunities to identify and treat physical health problems are being systematically 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.
Prof Subodh Dave, president of the Royal College of Psychiatrists, echoed this concern.
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 is the government's response?
A Department of Health and Social Care spokesperson acknowledged the problem, stating that
people living with severe mental illness face stark health inequalities, and too many continue to experience poorer physical health outcomes.The government announced it is taking immediate action to transform services, including developing a new modern service framework to determine what action is needed to help people live healthier and longer lives through high-quality care. The department is also opening 100 new community mental health centres and developing a mental health strategy to build a more integrated system that responds earlier and reduces waiting times for support.
These commitments come as the government's independent review of mental health, autism and ADHD, which was launched on 10 June 2026 and has a collection page last updated on 21 September 2026, continues to develop recommendations for transforming support across these conditions. The review represents a broader acknowledgement that mental health services require fundamental restructuring to address both mental and physical health outcomes.
What happens next?
The independent review into mental health conditions, ADHD and autism remains ongoing, with further outputs expected to follow the latest collection update on 21 September 2026. The NHS England suicide-in-severe-mental-health-problems release covers data through 2022-2024, with the next scheduled annual-style update anticipated in the following reporting cycle. These developments will shape policy responses to the health inequalities now documented in the September 2026 data.
Key Facts
- Adults with severe mental illness referred to secondary mental health services are 4.8 times more likely to die before age 75 than the general population
- Cancer and cardiovascular disease deaths among working-age adults with mental illness have reached their highest levels since records began, each exceeding 24,000 deaths in 2022-2024
- Diagnostic overshadowing – wrongly attributing physical symptoms to mental illness – prevents proper investigation and treatment of physical health conditions
- The government is developing a new service framework and opening 100 new community mental health centres as part of its response
- An independent review of mental health, autism and ADHD is ongoing, with further recommendations expected
