Preventing Premature Death in Persons with Severe Mental Illness

Increasing numbers of persons with mental illness in both developing and developed countries are dying at earlier ages. In developing countries, the major problem is poverty and the inability to obtain treatment largely as a result of the shortage of health and mental health professionals who are increasingly recruited to work in developed countries. In developed countries, those who are treated lose between 15 and 25 years of life and their numbers may now exceed annual mortality for HIV. As with the general population, the major cause of death is Cardiovascular disease and Coronary Heart disease (CHD) which accounts for 36% of all deaths. While heart disease has declined in recent years for the general population as a result of diagnosis and treatment, it has increased along with diabetes, dyslipidemia, hypertension and obesity for the SMI. In this presentation, we shall discuss the putative factors (patient characteristics, absence or ineffective prevention and early diagnosis,undertreatment and the increasing use of Atypical antipsychotic medication) for morbidity and mortality. Prevention strategies such as alerting the media;pooled data bases,aggressive monitoring and screening for medical conditions,involvement of primary care,endocrinologists and cardiologists in the care and treatment of this at risk population.