Life expectancy gap for people with severe mental illness, study warns

A survey of 2,000 adults by King’s Health Partners, Maudsley Charity and the Policy Institute at King’s College London found the public typically believes SMI shortens life expectancy by just seven years. Only one in nine respondents correctly identified the true scale of the gap, which is greater than the impact of smoking, severe obesity or type-1 diabetes.

Researchers say the lack of awareness reflects a wider failure to recognise that most early deaths among people with schizophrenia, bipolar disorder and psychosis stem from preventable physical illnesses – particularly cardiovascular and respiratory disease – rather than suicide or substance misuse, as half of the public incorrectly assume.

The findings expose stark inequalities. Very few people understood that SMI is more prevalent among Black communities, deprived areas and urban populations, reinforcing concerns that structural disadvantage compounds already poor health outcomes.

While two-thirds of the public agree more must be done to improve life expectancy for those with SMI, opinion is split on whether it is achievable or should be prioritised by the NHS. Younger adults are the least convinced, despite mental ill-health now being seen as the nation’s biggest health problem alongside cancer.

The research also suggests public perception has shifted faster than the system: although 72% of people view mental and physical health as equally important, only a third believe the NHS treats them that way. Mental health currently accounts for just 8.8% of NHS spending, a proportion expected to fall slightly next year following changes to the mental health investment standard.

Leaders from across the partnership stressed that the mortality gap is both severe and solvable. They pointed to evidence showing that proactive physical health screening, integrated care pathways and effective medication management can significantly reduce the risk of early death. A roundtable of NHS, academic and community organisations will meet later this month to examine the evidence and develop solutions.

Professor Matthew Hotopf CBE, Deputy Executive Director of King’s Health Partners, said the findings expose “one of the greatest health inequalities of our time”, adding that preventable deaths will continue unless services recognise and respond to the physical health needs of people with severe mental illness.

“People with severe mental illness face one of the greatest health inequalities of our time, dying 15 to 20 years early. Yet our findings show the public has little awareness of the scale of this mortality gap, or that it’s driven primarily by treatable physical health conditions. This hidden health crisis demands urgent attention and King’s Health Partners is committed to driving this change. As a university health partnership between two physical health NHS Foundations Trusts, a mental health NHS Foundation Trust and a world-leading university, we are uniquely placed to test innovations locally while influencing national and global policy and practice to close the mortality gap for people with severe mental illness.”

For practitioners across social care, the study underscores the importance of holistic assessments, assertive advocacy around physical healthcare, and addressing the structural inequalities that continue to put people with SMI at greater risk of avoidable harm.

Maudsley Charity Chief Executive Sarah Holloway said: “For too long, we have accepted early deaths of people with severe mental illness, but they are preventable.”

“Two thirds of the public agree that better healthcare needs to be provided to improve the life expectancy of those with SMI, and that includes proactive physical health screening and basic reasonable adjustments in all physical health services and pathway. We are committed to working with partners to spread and scale what we know works in reducing premature deaths for people with SMI, in South London and beyond.”