Excess under-75 mortality in adults with serious mental illness

The first domain of the NHS Outcomes Framework captures how successful the NHS is in reducing the number of avoidable deaths. One area for improvement in this domain is to reduce premature mortality in people with serious mental illness. This indicator measures the extent to which adults with a serious mental illness die younger than adults in the general population.

Do mortality rates for adults with a serious mental illness differ from those of the general population in England?

Mental Health mortality

Here we are looking at the extent to which adults with a serious mental illness die younger than adults in the general population. For more information about how this is calculated, see 'about this data' below.

The mortality rates for people under the age of 75 with a serious mental illness are over three times higher than the mortality rates for the general population in England. There has been little progress in reducing this gap over the time period measured. In 2014/15, the mortality rate for men and women with a serious mental illness was about 3.7 times higher than that of adults in the general population.

Updated January 2018.

About this data

The indicator value is the indirectly standardised ratio (expressed as a percentage) of the observed number of deaths of adults aged 18 to 74 in contact with secondary mental health services to the expected number of deaths in that population based on age- and sex-specific mortality rates in the general population.

The mental health mortality rate is directly age and sex standardised to the national population. This is then compared to the general population mortality rate using a standardised mortality ratio.

The mental health population is defined as anyone who has been in contact with secondary mental care services in the current financial year or in either of the two previous financial years who is alive at the beginning of the current financial year.

This indicator uses data from the Mental Health Minimum Data Set, the Primary Care Mortality Database and Office for National Statistics (ONS) population estimates.

For full indicator specification, please see the NHS Outcomes Framework Domain 1 Indicator Specifications.


We have known this for a while, yet little traction. We keep focussing on the problems, let's problem solve. Put the management and resourcing of mental & physical health back together. And let's have some equality in the application of rules! When I pay my taxes I pay towards the NHS, not community , acute or mental health separately! I shouldn't have to worry about organisations and their boundaries, and I certainly expect my GP or someone similar to steer me through! Just so fed up of silos and organisational priorities instead of patient priorities!

Ela Pathak-Sen (not verified)
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Dear Ela

Thank you very much for your interest in the project and in particular this indicator. We know these things can sometimes be frustrating and we are planning to do more work to understand how mental health services fit into the broader picture. You can read more about the work both organisations do here: http://www.nuffieldtrust.org.uk/about/what-we-do, http://www.health.org.uk/about-us/.

Best wishes

QualtyWatch team

QualityWatch Team (not verified)
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I'm trying to understand why we (quite rightly) fund drugs that will extend the life of someone who has cancer by, say 12 months, at £20-30k but don't fund IAPT treatments for people with mental illnesses which cost less and would increase the total quality-adjusted life years by considerably more. It seems doubly unfortunate that a person with a mental illness is not only being left in misery but, if I've got this right, is having his own life shorted because he's 3x more likely to die than a healthy person.

Again, if I understand it correctly, it looks like blatant discrimination.

I'd really appreciate it if someone could explain where I've gone wrong - it can't be as bad as it looks, surely?

Roger Sharp (not verified)
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Dear Roger,

Thank you for your interest in our work. One of our forthcoming Focus On reports will explore the differences in patterns of physical health service use for mental health service users and people who have no record of mental health service use.

Best wishes,
QualityWatch team

QualtyWatch team (not verified)
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Great project. It's good to see this data being presented so clearly - I think we need a frank and honest understanding of the root causes of this and a multi-pronged approach to trying to reduce this gap. An essential start is recognising that these issues are not necessarily easy to solve but that a positive collaborative approach to attempting to solve them is crucial.

Paul Rowlands (not verified)
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