Life expectancy and causes of death in a population treated for serious mental illness.
Abstract
OBJECTIVE: This cross-sectional mortality linkage study describes the prevalence of specific fatal disease and injury conditions in an adult population with serious mental illness. The large sample of decedents and the use of multiple-cause-of-death data yield new clinical details relevant to those caring for persons with serious mental illness. METHODS: Age-adjusted frequency distributions and years of potential life lost were calculated by gender and causes of death for persons in the population of 43,274 adults served by the Massachusetts Department of Mental Health who died between 1989 and 1994. Means and frequencies of these variables were compared with those for persons in the general population of the state who did not receive departmental services and who died during the same period. RESULTS: A total of 1,890 adult decedents served by the department of mental health were identified by electronic linkage of patient and state vital records. They had a significantly higher frequency of deaths from accidental and intentional injuries, particularly poisoning by psychotropic medications. Deaths from cancer, diabetes, and circulatory disorders were significantly less frequently reported. On average, decedents who had been served by the department of mental health lost 8.8 more years of potential life than decedents in the general population-a mean of 14.1 years for men and 5.7 for women. The differential was consistent across most causes of death. CONCLUSIONS: Findings in this study are consistent with previous findings identifying excess mortality in a population with serious mental illness. The high rate of injury deaths, especially those due to psychotropic and other medications, should concern providers.
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Compared with the Massachusetts study, the impact of SMI on life expectancy in our sample was weaker for men and stronger for women.
“a stronger impact for men and weaker impact for women compared to findings from our sample.”
From Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London (2011) · cites this paper as [1]
Despite healthcare improvements, there has been little evidence of benefit on life expectancy in people with SMI.
“Despite healthcare improvements, there has been little evidence of benefit on life expectancy in people with SMI [1], [20], [21]”
From Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London (2011) · cites this paper as [1]
A loss of 8.8 life years (14.1 years for men and 5.7 years for women) was estimated in a comparison between people treated for SMI and the general population in Massachusetts, US.
“a loss of 8.8 life years (14.1 years for men and 5.7 years for women) was estimated in a comparison between people treated for SMI and the general population in Massachusetts, US [1].”
From Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London (2011) · cites this paper as [1]
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Harm Reduction in Community Mental Health Settings
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Ethico-legal issues in relation to end-of-life care and institutional mental health
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Socioeconomic Stratification and Mental Disorder
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Understanding the Connection between Social Support and Mental Health
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Brief Reports: Elevated Cancer Incidence Among Adults With Serious Mental Illness
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Use of HIV and Psychotropic Medications among Persons with Serious Mental Illness and HIV/AIDS
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Active Medical Conditions Among Patients on an Assertive Community Treatment Team
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Gender-related concerns of rural women with severe and persistent mental illnesses.
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Medication decision-making by persons with serious mental illness
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Substance Use and Five-Year Survival in Washington State Mental Hospitals
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Improving the Health of Mental Health Consumers: Effective Policies and Practices
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Mental health and unintentional injurers: results from the national co-morbidity survey replication
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Rethinking Rehabilitation: Freedom
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Elders with Serious Mental Illness: Lost Opportunities and New Policy Options
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The Burden of Disease in Those With Serious Mental and Physical Illnesses
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- Authors
- Dembling, B. P., Chen, D. T., & Vachon, L.
- Affiliations
- University of Virginia (US)
- ORCID
- Chen, Donna T.
- Venue
- Psychiatric Services
- Published
- 1999-08
- Volume
- 50
- Issue
- 8
- Pages
- 1036-1042
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2116035776
- Cited by
- 202
- References
- 26
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 40 · 2016: 3 · 2015: 5 · 2014: 9 · 2013: 11 · 2012: 8
- FWCI
- 7.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2t32mh019292-11, 5p50mh049173-06)
- National Institute of Mental Health (P50-MH-49173-4A1, MH-19292-04)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- severe mental illness, excess mortality, causes of death, years of potential life lost, trauma mortality, accidental death, cancer mortality, diabetes mortality, circulatory diseases, mental health service users, Massachusetts Department of Mental Health
- MeSH terms
- Adolescent, Adult, Mental Disorders, Cause of Death, Cross-Sectional Studies, Female, Humans, Life Expectancy, Male, Massachusetts, Poisoning, Psychotropic Drugs, Wounds and Injuries
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