Dr Mike Trott study shows life expectancy gap narrowed for most severe mental health patients

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A retrospective population-based cohort study tracking 255,448 individuals across Queensland hospitals between 2009 and 2023 shows that the life expectancy gap for people with severe mental health conditions has narrowed for most demographics. Researchers found that the mortality gap dropped from 13.4 to 9.4 years in females and from 16.7 to 12.1 years in males over the 14-year period. However, the data reveals that the gap did not narrow significantly for individuals diagnosed with schizophrenia or other psychoses.

Severe Psychotic Disorders Left Behind in Mortality Gap Reduction

Lead author Dr. Mike Trott, head of Epidemiology and a Research Fellow in Psychiatric Epidemiology and Evidence Synthesis at the University of Queensland and Metro South Addiction Mental Health Services in Brisbane, pointed to the broad positive trajectory while highlighting a persistent exception.

There have been some improvements. But that gap is still there. And it’s still massive. That is still a long time to be dying earlier than the general population. Historically that’s been called a scandal of premature mortality. And it’s still the case.

Dr. Mike Trott

The study analyzed adult admissions for severe mental health conditions, including schizophrenia, affective psychoses, alcohol or substance use disorders, neurotic disorders, stress and adjustment reactions, and depressive disorders. While general metrics improved, the mortality gap remained static for patients with schizophrenia and other psychoses, as well as females with affective psychoses, neurotic disorders, or alcohol and substance use disorders.

Physical Illness Drives Most Premature Deaths

While intentional self-harm represented the largest single cause of death in absolute numbers, the combined mortality rate from physical health conditions proved substantially greater. The researchers found that physical illnesses, including cardiovascular disease and various cancers, accounted for most deaths among patients. All cancers represented the highest cause-specific mortality rate in both sexes across the cohort. The combined excess mortality rate from physical health causes reached approximately 2.7 times the mortality by self-harm rate for males and 5.3 times for females. Dr. Trott emphasized that these physical conditions are largely preventable through proactive monitoring.

Treatment Stagnation and Call for Systemic Key Performance Indicators

Dr. Trott attributed the lack of progress in psychotic disorders to a prolonged absence of therapeutic breakthroughs. Everything is chipping away. But there hasn’t been a kind of therapeutic breakthrough, he said, noting that treatments for schizophrenia have seen no major forward movement in 15 to 20 years. To address the physical health disparities, Dr. Trott suggested that physical health monitoring must be linked to performance metrics for health care professionals. Implementing key performance indicators across primary and secondary care systems would drive institutional change, despite the operational challenges and high patient volumes currently facing hospital emergency rooms.

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