12 November 2026
People living with severe mental illness are around four times more likely to die early from cardiovascular disease (CVD) than the general population in England, according to a major new report published by the Royal College of Psychiatrists, British Heart Foundation, Centre for Mental Health and Equally Well UK.
The report, Left Behind: A Policy Response to Cardiovascular Inequalities in Severe Mental Illness, highlights significant disparities in the prevention, diagnosis and treatment of heart and circulatory disease for people living with severe mental illness, including schizophrenia, bipolar disorder and other psychotic illnesses.
Evidence shows depth of inequality
Evidence cited in the report shows that people with severe mental illness are:
- Around four times more likely to die prematurely from cardiovascular disease.
- 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% having undiagnosed CVD before cardiovascular death.
The report also highlights higher rates of modifiable risk factors, including smoking and obesity. Obesity rates are 1.8 times higher among people with severe mental illness than in the wider population, while more than 40% are estimated to smoke. Smoking alone is thought to account for around half of all deaths among people living with severe mental illness.
According to the report, these inequalities are driven not only by clinical risk factors but also by deprivation, stigma and fragmented services , which shape both mental and physical health but are particularly impactful for people living with severe mental illness.
We also know that people living with severe mental illness are more likely to encounter diagnostic overshadowing– when healthcare providers mistakenly attribute physical health symptoms to a person's pre-existing mental health condition. Patients reported experiences of physical symptoms being dismissed or overlooked and difficulties navigating disconnected services.
A patient who has spoken openly about his experience is Robert, 62, from north-west London, who lives with cyclothymia and post-traumatic stress disorder (PTSD), alongside episodes of irregular heart rhythm (arrhythmia), high blood pressure, a thyroid condition and high cholesterol.
He speaks of how the “cocktail” of 12 or 13 tablets a day breeds worry about interactions with mental health medication and leads to poor sleep, which negatively impacts his mental health.
He says, “ I want healthcare professionals to consider my physical symptoms and mental health together, rather than treating them as separate issues. Sadly, that has not always been my experience.. We need to be understood as whole people, with concerns and needs that do not fit neatly into separate services.”
Six recommendations to tackle inequalities
The College is joining the organisations behind the report to call on the UK G government, the NHS and local health systems to take action through six key recommendations, including reducing smoking rates, improving access to healthy food and weight management support, strengthening cardiovascular monitoring, increasing liaison psychiatry input within cardiology services, and expanding use of the Lester Tool for physical health monitoring.
Dr Ed Beveridge, the Royal College of Psychiatrists’ College’s Expert on Physical Health, said,
“People living with severe mental health conditions are significantly more likely to die early and cardiovascular disease is implicated in about half of these cases. We know that this is at least partly because they often have worse access to health care and the impact of mental illness is often not sufficiently taken into account when physical conditions are being addressed.
“It is absolutely vital that we ensure people living with mental health conditions have equitable access to screening and treatment, to minimise the risk of preventable death and help them lead lives which are healthier as well as longer. I am very pleased to have been involved in this important piece of work, whose recommendations have the potential to make a real impact on our patients' lives.”
The report comes as policymakers develop a new Mental Health Strategy and a Modern Service Framework for Severe Mental Illness, with the authors arguing that cardiovascular health must be a core part of future mental health policy and service planning.
Read the full report: Left Behind: A Policy Response to Cardiovascular Inequalities in Severe Mental Illness.
For further information, please contact:
- Email: press@rcpsych.ac.uk
- Out-of-hours contact number: 07860 755896