Priority 3: Achieve parity of esteem between physical and mental illness

This is the third of five priorities we've included in Preventing mental illness, our manifesto for the next UK General Election.

Address the treatment and mortality gap for people with mental illness

People with mental illness and severe mental illness are not receiving treatment when they need it. In England alone, 4.5 million people accessed NHS mental health services in 2021/22, while approximately 8 million people with mental health needs are currently not receiving care from services¹. As of June 2023, almost 254,000 people out of nearly 528,000 people (48.1%) with a severe mental illness in England were yet to receive all six components of a physical health check in the past year. Many with mental illness are not known to or accessing services at all, particularly in minoritised ethnic groups and underserved populations.

The life expectancy of patients with severe mental illness is 15 to 20 years lower than the general population². Adults with a severe mental illness (e.g., enduring psychosis, bipolar disorder, schizophrenia) are almost five times more likely to die before the age of 75 than those without and this mortality gap is widening over time. 120,273 adults in England with severe mental illness died before the age of 75 between 2018 and 2020, and 80,182 of these deaths were from physical illnesses, like cancer and heart disease, which could have been prevented with earlier detection and treatment or lifestyle changes³. Physical health problems are too often missed or overlooked in this group.

Inequality engenders mental illness, and people with mental illness are treated inequitably – a cycle that must end. We need systems and a workforce in place which are empowered to address health inequalities and improve outcomes for people with a severe mental illness.

Recommendations

• Implement agreed reforms to mental health and capacity legislation to ensure adequate access to mental health treatment, while maximising patient autonomy.
• Fund and properly resource mental health services to address the treatment and mortality gap for people with mental illness and severe mental illness.
• Expand and widen the scope of regular health checks with appropriate resourcing to increase the provision of comprehensive physical assessments for people with diagnosed mental illness.

References

1. National Audit Office, Progress in improving mental health services in England, 9 February 2023.
2. Office for Health Improvement & Disparities (OHID), Severe mental illness (SMI) and physical health inequalities: briefing, 27 September 2018
3. OHID, Severe Mental Illness, 7 March 2023