Reduced life expectancy among patients served in public mental health systems: Findings from San Mateo County, California

San Mateo County provides a broad range of mental health services to people with serious mental illness. Recent studies have shown that adults receiving mental health services may have a lower life expectancy than the average American, possibly due to effects of certain antipsychotic drugs. This study examined the association between life expectancy and the receipt of public mental health services. All patients seen by the County mental health system from 2002 to 2006 were matched to death certificate data. Mean age at death, years of potential life lost and cause of death were compared with those for persons in the general population who did not receive public health services and who died during the same period. Of the 39,639 clients served by the County, a total of 553 decedents were identified by the matching process. Mental health clients had a significantly higher rate of deaths from cardiovascular disease, injuries and alcohol related gastrointestinal causes. Among mental health patients, the mean overall age at death and death due to cardiovascular disease was 62 and 68, respectively, compared to 74 and 80 for the general population. On average, mental health decedents lost 1.75 years of life for every 1 year in the general population. These preliminary results indicate that there is a significant decrease in life expectancy among patients receiving mental health services and these findings are consistent with previous studies. Further analysis is needed to consider socio-economic factors, medical care, individual risk factors the potential metabolic effects of second-generation antipsychotics.