The impact of serious mental illness on health and healthcare.
BACKGROUND
Patients with serious mental illness (SMI; e.g., psychotic disorders and major mood disorders) die earlier, have more medical illnesses, and receive worse medical care than those in the general population.


OBJECTIVE
The aims of this article are to review the data on medical morbidity and mortality in those with SMI, to highlight the factors that lead to such disparities, and to discuss potential solutions to the problem.


METHODS
The authors reviewed the literature on medical morbidity and mortality in those with SMI.


RESULTS
Adults with SMI in the United States die 25 years earlier than those in the general population; cardiovascular disease is responsible for the majority of this excess mortality, accounting for roughly 50%-60% of the deaths due to medical illness. Patient, provider, and system-level factors interact to contribute to poor health outcomes in people with SMI.


CONCLUSIONS
Patients with SMI are losing many years of life to preventable and treatable medical illnesses. Solutions to the problem will require attention to patient, provider, and system-level factors.
correspondence and M.D., Dept. of Psychiatry, Massachusetts General Hospital, 15 Parkman St., WACC 812, Boston, MA 02114, USA. mviron@partners.org
Mark J
MJ
Viron
Theodore A
TA
Stern
D015897:Comorbidity; D017281:Cost of Illness; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D001523:Mental Disorders / Q000401:mortality* / Q000628:therapy*; D009017:Morbidity; D011320:Primary Health Care; D011787:Quality of Health Care; D012307:Risk Factors