Adults with severe mental illness in England die 15–20 years earlier than other adults, according to an analysis of NHS data by the charity Rethink Mental Illness. People with serious mental disorders are 4.8 times more likely to die before the age of 75 than the general population.
The figures point to physical illness as the main driver of the gap. Cancer, cardiovascular and respiratory diseases, along with liver disease, accounted for 56.5% of all deaths among people aged 18 to 74 with severe mental illness in England in 2022–2024. These illnesses are often detected late or treated insufficiently, the charity said.
The analysis was released in September 2026 alongside official NHS England statistics on mortality and excess mortality. It covers adults referred to specialist secondary mental health services, a group that includes some of the most acute cases in the NHS system.
Cancer accounted for just under 19% of deaths among people aged 18 to 74 with severe mental illness in 2022–2024. Cardiovascular diseases also accounted for just under 19%. Respiratory diseases made up 11% of deaths, while liver disease accounted for 8%.
More than 24,000 deaths from cancer were registered in the group during the period. More than 24,000 deaths were also registered from cardiovascular diseases.
The risks were substantially higher than in the general population. People with serious mental disorders were 6.3 times more likely to die from liver disease. Their likelihood of death from respiratory diseases was six times higher, while the risk was 3.8 times higher for cardiovascular diseases and 2.3 times higher for cancer.
Suicide remained a major danger for people using specialist mental health care. Mortality from suicide was 14.6 times higher among people referred to specialist mental health services than among those not referred. Yet suicides accounted for 7% of premature deaths among people aged 18 to 74 with severe mental illness, below the share attributed to the major physical diseases identified in the analysis.
Rethink Mental Illness said the mortality gap reflected failures across prevention, diagnosis and treatment, as well as wider social pressures. The factors cited included poverty, poor housing conditions, higher smoking rates, medication-induced weight gain, lack of physical activity and fragmented health services.
The charity also highlighted “diagnostic shadowing”, in which clinicians wrongly ascribe physical symptoms to a patient’s mental state. Such assumptions can delay investigation of physical illness and reduce the chance of treatment at an earlier stage.
Mark Winstanley, the chief executive of Rethink Mental Illness, said patients frequently contacted health services, yet opportunities to identify and treat physical health problems were still being lost. The findings suggest that contact with mental health services has not consistently resulted in joined-up physical healthcare.
Subodh Dave, president of the Royal College of Psychiatrists, called for systematic action. He said this should include smoking cessation programmes and regular physical health checks.
The analysis does not establish whether the 15–20 year gap has changed over time. It also provides no comparison with other UK nations or international health systems, and does not identify whether outcomes differ sharply between NHS regions. It nevertheless sets out the scale of early mortality among adults with severe mental illness and the central role of conditions for which earlier detection, prevention and treatment may be possible.
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