title: A Surveillance System to Monitor Excess Mortality of People With Mental Illness in Canada.
abstract: OBJECTIVE
  Outcome measures are rarely available for surveillance and system performance monitoring for mental disorders and addictions. Our study aims to demonstrate the feasibility and face validity of routinely measuring the mortality gap in the Canadian context at the provincial and regional levels using the methods and data available to the Canadian Chronic Disease Surveillance System (CCDSS) of the Public Health Agency of Canada.
  
  
  METHODS
  We used longitudinal data from the Quebec Integrated Chronic Disease Surveillance System, which also provides aggregated data to the CCDSS. This includes data from the health insurance registry physician claims and the hospital discharge abstract for all mental disorder diagnoses (International Classification of Diseases [ICD]-9 290-319 or ICD-10 F00-F99). Patients were defined as having had received a mental disorder diagnosis at least once during the year. Life expectancy was measured using Chiang's method for abridged life tables, complemented by the Hsieh method for adjustment of the last age interval.
  
  
  RESULTS
  We found a lower life expectancy among psychiatric patients of 8 years for men and 5 years for women. For patients with schizophrenia, life expectancy was lowered by 12 years for men and 8 years for women. Cardiovascular disease and cancer were the most common causes of premature death. Findings were consistent across time and regions of the province. Lower estimates of the mortality gap, compared with literature, could be explained by the inclusion of primary care patients and methods.
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility of using administrative data to measure the impact of current and future mental health plans in Canada provided the techniques can be replicated in other Canadian provinces.
authors.affiliation: Professor, Department of Psychiatry, University of Montreal, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Quebec; Invited Psychiatric Expert, Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Quebec, Quebec.
authors.forename: Alain
authors.initials: A
authors.lastname: Lesage
authors.affiliation: Statistician, Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Quebec, Quebec.
authors.forename: Louis
authors.initials: L
authors.lastname: Rochette
authors.affiliation: Head, Chronic Disease Surveillance Unit, Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Quebec, Quebec.
authors.forename: Valérie
authors.initials: V
authors.lastname: Émond
authors.affiliation: Epidemiologist, Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Quebec, Quebec.
authors.forename: Éric
authors.initials: É
authors.lastname: Pelletier
authors.affiliation: Scientific Director, Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Quebec, Quebec.
authors.forename: Danielle
authors.initials: D
authors.lastname: St-Laurent
authors.affiliation: Research Coordinator, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Quebec.
authors.forename: Fatoumata Binta
authors.initials: FB
authors.lastname: Diallo
authors.affiliation: Professor, Queensland Centre for Health Data Services, University of Queensland, Brisbane, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kisely
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003866:Depressive Disorder / Q000453:epidemiology; D062665:Epidemiological Monitoring; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009026:Mortality; D009369:Neoplasms / Q000401:mortality*; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000453:epidemiology; D055815:Young Adult