People with severe mental illness are dying more than a decade earlier than the general population, and researchers say the reason is not only what happens in the mind, but what happens throughout the body.
A University of Queensland-led study analyzing 14 years of hospital mortality data found that men with severe mental-health disorders died an average of 12 years earlier than the general population. In comparison, women died about 10 years earlier. The findings reveal a persistent health inequality: preventable physical illnesses, especially cardiovascular disease, are playing a major role in the gap.
The research also challenges a common assumption about why people with severe mental illness die younger. Suicide remains an important concern, but researchers say physical illnesses (including heart disease, diabetes, respiratory disease, and other chronic conditions) account for much of the excess mortality.
The issue affects millions of people. In the United States, an estimated 14.6 million adults experienced serious mental illness in 2024, representing about 5.6% of adults.
The message isn’t that mental illness alone determines life expectancy. Instead, the gap reflects a combination of physical-health risks, medication effects, social conditions, stigma, and healthcare systems that often treat mental and physical health separately.
The Life Expectancy Gap Is More Than 10 Years
The University of Queensland study analyzed approximately 255,000 hospital patients over 14 years in Queensland, Australia. Researchers included people with depressive, neurotic and stress-related disorders, alcohol and drug-use disorders, and schizophrenia or other psychotic disorders.
They found that males with severe mental-health disorders died about 12 years earlier than the general population, while females died about 10 years earlier.
The study also found some encouraging signs. Overall mortality improved during the research period, suggesting that healthcare improvements have helped some people with mental-health conditions live longer.
But the progress was not equal.
For people with psychotic disorders, including schizophrenia, mortality rates did not improve in the same way. Lead researcher Dr. Mike Trott said the mortality rate for patients with psychosis had “flatlined,” highlighting that people with the most complex needs have not benefited equally from broader improvements in care.
The Overlooked Driver Is Physical Health
When people discuss early deaths among those with severe mental illness, the conversation often focuses on psychiatric symptoms.
Researchers say the bigger picture is more complicated.
Physical illnesses are major contributors to the life expectancy gap. Cardiovascular disease, diabetes, respiratory disease, cancer, and infections all play a role in premature death among people with mental illness. AIHW estimates that around four in five premature deaths in this population are linked to potentially preventable physical health conditions.
The World Health Organization has similarly reported that severe mental disorders are associated with a 10- to 20-year reduction in life expectancy, with most premature deaths linked to physical health conditions rather than mental illness alone.
That means closing the gap requires looking beyond psychiatric treatment and asking a broader question: Are people receiving the same opportunities to prevent, detect, and treat physical illness?
Lifestyle Risks Are Not Simply About Personal Choices
Photo Credit: Basil MK/Pexels
Smoking, physical inactivity, poor diet quality, alcohol and drug use, and disrupted sleep can all increase the risk of chronic disease.
Smoking rates among people with severe mental illness have been reported as high as 80% in some studies. One analysis found that people with schizophrenia who smoked had an 86% higher 20-year cardiovascular mortality risk than nonsmokers with schizophrenia.
But researchers caution against viewing these risks as simple individual decisions.
People living with severe mental illness may face challenges that make healthy routines harder to maintain. Symptoms such as depression, anxiety, psychosis, or cognitive difficulties can affect motivation, planning, concentration, and the ability to manage appointments or daily tasks.
Social conditions can add another layer. Poverty, unstable housing, food insecurity, transportation problems, and stigma can all affect whether someone can access preventive care, afford healthier options, or maintain consistent treatment.
The result is a cycle in which health risks can build over time while opportunities for early intervention are missed.
Related: Five Everyday Lifestyle Changes Being Discussed for Mood and Mental Wellbeing
Medication Can Help, But Monitoring Matters
Medication is an important part of treatment for many people with severe mental illness. However, some psychiatric medications can also affect physical health.
Certain antipsychotic medications, for example, may contribute to weight gain and metabolic changes. Researchers emphasize that this does not mean people should stop prescribed medication, but it does highlight the importance of monitoring physical health alongside mental-health treatment.
That can include regular checks for blood pressure, cholesterol, blood sugar, weight changes, and other risk factors for cardiovascular disease and diabetes.
The goal is not to choose between mental and physical health. It is to treat both.
A Healthcare System Problem, Not Just A Health Problem
One of the biggest barriers is that mental and physical healthcare are often delivered separately.
A person may receive treatment for psychiatric symptoms while missing routine screening for high blood pressure, diabetes, cholesterol problems, smoking-related disease, or medication-related metabolic changes.
Dr. Trott said the research shows physical illness is the principal driver of excess mortality and that prioritizing physical health alongside mental-health care could be essential for reducing the gap, particularly among people with psychotic disorders.
That means improving life expectancy will likely require more than encouraging lifestyle changes. It will require easier access to primary care, preventive screening, smoking-cessation support, addiction treatment, nutrition support, movement programs, and social connection.
Closing The Gap Means Treating The Whole Person
Improving longevity for people with severe mental illness will require more than telling people to exercise more or eat better.
Lifestyle support can help, but researchers and health organizations emphasize that it works best alongside psychiatric care, primary care, medication monitoring, smoking-cessation support, addiction treatment, and social support.
The World Health Organization recommends integrating mental and physical healthcare, including support for cardiovascular risk, diabetes, tobacco dependence, substance use, and weight-related health concerns.
Access remains part of the challenge. Federal estimates show that about two-thirds of U.S. adults with serious mental illness received mental-health treatment in 2025, meaning roughly one in three did not receive treatment during that period.
The larger lesson is that closing the life expectancy gap is not only a mental-health issue. It is a physical-health issue, a healthcare-access issue, and a question of whether people receive the coordinated care needed to protect their long-term health.
Why do you think society often overlooks physical health when it talks about mental-health care?
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