Toby House, Inc.

Mental disorders generate an immense public health burden of disability. The World Health Organization's Global Burden of Disease Study has found that the impact of mental illness on overall health and productivity in the United States and throughout the world is profoundly under-recognized.

Mental illness is on par with heart disease and cancer as a cause of disability. The study also reported that mental disorders comprise four of the top five sources of premature death and disability in 15-44 year olds in the Western world. Schizophrenia, bipolar disorder, depression, autism, and other mental disorders are serious, often life-threatening illnesses for which we need reliable diagnostic tests, new treatments, and effective strategies for prevention.

This fact is seldom discussed, though unfortunately true, the death rate is in fact significantly higher for those who are severely mentally ill than it is for the general population. This finding is well established and has been reported in numerous studies. The mortality rates for both natural and unnatural causes of death are more than twice that of the general population. Individuals with severe mental illness die 19 years prematurely. The average age of death for the severely mentally ill population is 52.4 years versus 72.8 years for the general population.

The largest single contributor to premature death is suicide, which is 10 to 15 times higher than in the general population. Also contributing to early death are poor health habits, including heavy smoking, obesity and alcohol abuse. The presence of diseases such as heart disease and diabetes, which may be undiagnosed and untreated account for a significant number of those who die prematurely. Accidental deaths are much higher in this population as well.

People with severe mental illness are at particularly high risk for early death because their needs have been ignored in service planning. Unavailability of services results in increased disability for many and impacts every aspect of their lives. People with mental disorders need new treatments, but they also need access to the successful, evidence-based treatments already developed through research.

The President's New Freedom Commission on Mental Health report describes the need to transform mental health care in America. As explained in this report, research must ensure that science in the laboratory links to service in the community.

Perhaps the most disheartening contributor to premature death among people with mental illness is the apathetic fatalism that surrounds them. The sense that their lot in life is preordained and the conclusion inevitable. This causative perception is ultimately the single greatest contributing factor most within our control.