Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states.

TLDR

Mortality rates serve as global health indicators, and most mental health clients die of natural causes similar to national leading causes, underscoring the need to integrate mental and physical health care. The study aimed to compare mortality, causes of death, and years of potential life lost among public mental health clients across eight states with their state general populations, highlighting the need for enhanced mortality tracking and integrated care. Data from eight state public mental health agencies (1997‑2000) were analyzed using age‑adjusted death rates, standardized mortality ratios, and years of potential life lost to compare client mortality with state general populations. Public mental health clients in all eight states had a higher relative risk of death, died at younger ages, lost decades of potential life, and those with major mental illness lost more years than those with non‑major diagnoses, with deaths largely due to natural causes such as heart disease, cancer, and cerebrovascular disease.

Abstract

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.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.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.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.