Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States

By Craig W. Colton, R. Manderscheid. Preventing Chronic Disease, 2006

1,304 citations recorded by the source corpus.

Introduction Mortality rates are used as global measures of a population's health status and as indicators for public health efforts and medical treatments. Elevated mortality rates among individuals with mental illness have been reported in various studies, but very little focus has been placed on interstate comparisons and congruency of mortality and causes of death among public mental health clients. Methods Using age-adjusted death rates, standardized mortality ratios, and years of potential life lost, we compared the mortality of public mental health clients in eight states with the mortality of their state general populations. The data used in our study were submitted by public mental health agencies in eight states (Arizona, Missouri, Oklahoma, Rhode Island, Texas, Utah, Vermont, and Virginia) for 1997 through 2000 during the Sixteen-State Study on Mental Health Performance Measures, a multistate study federally funded by the Center for Mental Health Services in collaboration with the National Association of State Mental Health Program Directors. Results In all eight states, we found that public mental health clients had a higher relative risk of death than the general populations of their states. Deceased public mental health clients had died at much younger ages and lost decades of potential life when compared with their living cohorts nationwide. Clients with major mental illness diagnoses died at younger ages and lost more years of life than people with non-major mental illness diagnoses. Most mental health clients died of natural causes similar to the leading causes of death found nationwide, including heart disease, cancer, and cerebrovascular, respiratory, and lung diseases. Conclusion Mental health and physical health are intertwined; both types of care should be provided and linked together within health care delivery systems. Research to track mortality and primary care should be increased to provide information for additional action, treatment modification, diagnosis-specific risk, and evidence-based practices.

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Citations in the corpus

• Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) (2009, background): “Epidemiological studies have consistently shown excess CVD mortality in patients with schizophrenia, bipolar disorder and depression [8,15,17,18,24,26,35,82,83,106,107,113,124].”
• Pharmacology of Nicotine: Addiction, Smoking-Induced Disease, and Therapeutics (2009, background): “People with chronic mental illness die on average 25 years earlier than individuals without those disorders, primarily due to cardiovascular disease and diabetes (59).”
• Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011, background): “The preponderance of evidence suggests that patients with major depression, bipolar disorder and schizophrenia are at significantly higher risk for cardiovascular morbidity and mortality than are their counterparts in the general population (2,9,11,23,28,29,287-295).”
• Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis (2010, background): “…consequences of the metabolic risk factors such as hypertension, type 2 diabetes, strokes and heart attacks (Anderson et al., 2003; Casey, 2004; Colton and Manderscheid, 2006) a careful individual decision for an antipsychotic, a close monitoring for metabolic side effects of the chosen…”
• 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, background): “Of the few studies to measure this outcome, clients with SMI from public mental health agencies in eight US states from 1997 to 2000 were found to have lower life expectancies of 13 to more than 30 years compared to the general population (depending on the year and state) [2], and a loss of 8.”