People living with severe mental illness in England are around four times more likely to die prematurely from cardiovascular disease than the wider population, according to a major new report from the British Heart Foundation, produced in partnership with Centre for Mental Health, Equally Well UK, and the Royal College of Psychiatrists.
The report, Left Behind: A Policy Response to Cardiovascular Inequalities in Severe Mental Illness, highlights significant inequalities in the prevention, diagnosis and treatment of heart and circulatory conditions among people living with severe mental illness.
Researchers found that people with severe mental illness not only face a higher risk of developing cardiovascular disease (CVD), but are also less likely to receive the care and support needed to prevent serious illness and premature death.
The report reveals a range of concerning disparities across the healthcare system.
People living with severe mental illness are:
- 47% less likely to undergo cardiac interventions.
- 15% less likely to have a recent prescription for statins.
- More likely to have cardiovascular disease go undetected, with up to 66% of patients having undiagnosed CVD before a cardiovascular-related death.
The findings suggest that, despite facing greater health risks, many patients with severe mental illness are missing out on timely diagnosis, preventative care and potentially life-saving treatment.
The report also highlights the prevalence of key cardiovascular risk factors among people with severe mental illness.
Obesity rates are estimated to be 1.8 times higher than in the general population, while smoking remains one of the most significant contributors to poor health outcomes. Researchers estimate that smoking accounts for around half of all deaths among people living with severe mental illness.
The report argues that these poor outcomes are not solely the result of clinical factors. Instead, it identifies wider issues such as deprivation, stigma, discrimination and fragmented healthcare services as major drivers of inequality.
Evidence gathered from patients shows that physical health concerns can sometimes be dismissed or overlooked because of an individual's mental health diagnosis.
The report also highlights how physical and mental health services often operate separately, creating barriers for patients who must navigate complex systems to access care.
As a result, many people experience delays in diagnosis and treatment, increasing the risk of preventable illness and early death.
In response, the British Heart Foundation, Centre for Mental Health and Equally Well UK are calling for coordinated action from government, the NHS and local healthcare systems.
Their recommendations include:
- Setting a 10-year target to reduce smoking rates among people with severe mental illness.
- Improving access to affordable and nutritious food.
- Expanding access to weight management support.
- Strengthening monitoring and follow-up through the NHS Annual Health Check programme.
- Improving integration between mental and physical healthcare services.
The organisations say a more coordinated and preventative approach is essential if the life expectancy gap is to be reduced.
Andy Bell, Chief Executive of Centre for Mental Health, said:
“That people living with severe mental illness can expect to die up to two decades before the rest of the population is one of the starkest health inequalities that exists in Britain today and a clear injustice. Entrenched discrimination and disadvantage don’t only affect the risk factors for cardiovascular disease amongst people with a mental illness. They also stop people getting the right help early on, or the necessary treatment when they become unwell. But this is not inevitable. It needs bold ambition, effective implementation, and reliable data to track progress.”
The report adds to growing calls for greater parity between physical and mental health services, particularly for people living with severe and enduring mental illness.
With cardiovascular disease remaining one of the leading causes of premature mortality among this population, campaigners argue that targeted prevention, better access to treatment and stronger integration of care could significantly improve outcomes and help reduce one of the most persistent health inequalities facing the NHS today.
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