How Much Earlier Do People With Serious Mental Illness Die?

Andrew Scull says a person with serious mental illness will die on average 15 to 25 years before everyone else, and the gap has been growing rather than diminishing.

A lot of the early death comes from public policy that has abandoned treatment for the seriously mentally ill, and he does not lay the whole failure at the door of psychiatry. On city streets, sidewalk psychotics cycle between brief periods of inpatient care, the gutter or the flophouse, and jail. The three largest centers of inpatient psychiatric care in the United States today are the Los Angeles County Jail, Cook County Jail in Chicago, and Rikers Island in New York. Prisons, by their nature, are not equipped to deal with serious mental illness, so the pattern is a dark return toward the asylum era.

When asylums were founded, the mood was enormous optimism about curing people. The plan was to rescue them from attics and from jail cells, give them a therapeutic environment, coax them to work, and teach them to keep their demons under wraps, not necessarily to drive the demons out. The expectation was that asylums would rescue people from horrendous conditions in the prisons and the jails and actively cure them.