If you know five people, chances are at least one lives with a mental health condition. More than 8.5 million Australians will need mental health treatment in their lifetime for depression, anxiety, substance use and/or psychosis.
But why these people? they die on average more than a decade earlier by people who do not have access to mental health support?
People aged 15–74 receiving treatment for make-up mental illness just over 22% of the total population. But they account for almost half (49.3%) of all premature deaths.
The vast majority die due to physical health problems – and can be prevented.
Life expectancy has increased for others
For the past 30 years, Australians as a whole have enjoyed one five to six years increase in life expectancy. This is largely due to improvements in health care and healthier behaviors, such as a reduction in smoking and advances in the early detection and treatment of cancer and heart disease.
However, people with mental illness have not enjoyed the same increases in life expectancy, leading to a widening gap.
This applies to a range of mental health conditions.
People with serious mental illnesses, such as psychosis, die an average of 14 years earlier than the general population. Those with more common mental illnesses, such as depression and anxiety, also face a shorter life expectancy, dying 9-13 years earlier.
What do people with mental illness die of?
Contrary to popular belief, the gap in life expectancy among people with mental illness is not due to suicide.
Suicide constitutes 1.6% of deathswhile the main causes of premature death are preventable physical conditions such as cancer, heart disease, respiratory disease and diabetes.
Our study for 2024 used national data to analyze chronic disease deaths among people with mental illness. We found they were two to six times more likely to die prematurely than the rest of the population.
For example, people with mental illness are five to six times more likely to die from breast or prostate cancer than the rest of the population and four times more likely to die from diabetes.
All in all, this leads to 16,658 preventable deaths for this population each year.
Why is this happening?
Many interconnected contributing factors in this health disparity. They include discrimination, socio-economic disadvantage, barriers to access, side effects of medication and the symptoms of mental illness itself.
People with mental illness often face prejudice and discrimination, including from health care workers, making them reluctant to seek care. When they raise health concerns, they may not be believedit is considered excessive or their symptoms are dismissed.
This is known as diagnostic shadowing. It means that one’s mental health condition “overshadows” one’s physical health and other concerns, and these are overlooked. This can mean that serious health issues go undetected and untreated.
People with mental illness also face other challenges in accessing preventive care and treatment. They are less likely to be vaccinated as well much less likely to access screening and treatment for conditions such as cancer and heart disease, meaning diagnosis is often made at a more advanced stage, reducing survival rates.
This may be due to poor communication by health workers, stigmatizing attitudes and accessibility problems such as lack of access to transport.
When people are socially isolated, live peripherally or face socio-economic disadvantage, they can find it even harder to access care – and are even more likely to die early than others with mental illness.
The drug’s side effects can also pose long-term health risks, such as developing obesity from using antipsychotic drugs.
What should change?
Health care is a human right. For Australia to meet its UN commitments – and turn the tide on preventable deaths – we have to make sure people with mental illness enjoy the same quality of care as the rest of the population.
This means educating the health care workforce about the dramatically higher risk of premature death among people with mental illness, training staff how to recognize and respond to physical health concerns without stigma.
Integrating GPs with community mental health teams and including people with mental illness in policy design and health services is also important.
We need nationally funded vaccination, smoking cessation and cancer screening programs that target people with mental illness. Regular monitoring and reporting can track progress and determine whether these programs are working to close the life expectancy gap.
As a friend, family member, carer or health professional of someone with a mental illness, you can also help. For example, asking when the person last had a physical health check, whether they had access to cancer screenings and vaccinations, and if they need support.
Something simple – like helping them book or attend an appointment – can make a big difference.
If this article has raised issues for you, or if you are concerned about someone you know, please call Life line on 13 11 14.
