Gone Too Soon: priorities for action to prevent premature mortality associated with mental illness and mental distress

O'Connor RC 1 , Worthman CM 2 , Abanga M 3 , Athanassopoulou N 4 , Boyce N 5 , Chan LF 6 Show all authors , Christensen H 7 , Das-Munshi J 8 , Downs J 9 , Koenen KC 10 , Moutier CY 11 , Templeton P 12 , Batterham P 13 , Brakspear K 14 , Frank RG 15 , Gilbody S 16 , Gureje O 17 , Henderson D 18 , John A 19 , Kabagambe W 20 , Khan M 21 , Kessler D 22 , Kirtley OJ 23 , Kline S 24 , Kohrt B 25 , Lincoln AK 26 , Lund C 27 , Mendenhall E 28 , Miranda R 29 , Mondelli V 30 , Niederkrotenthaler T 31 , Osborn D 32 , Pirkis J 33 , Pisani AR 34 , Prawira B 35 , Rachidi H 36 , Seedat S 37 , Siskind D 38 , Vijayakumar L 39 , Yip PSF 40

Affiliations 

  • 1 Suicidal Behaviour Research Laboratory, School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. Electronic address: rory.oconnor@glasgow.ac.uk
  • 2 Department of Anthropology, Emory University, Atlanta, GA, USA
  • 3 Hope for the Abused and Battered, Douala, Cameroon
  • 4 IfM Engage, University of Cambridge, Cambridge, UK
  • 5 Wellcome Trust, London, UK
  • 6 Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
  • 7 Faculty of Medicine & Health, University of New South Wales, Sydney and the Black Dog Institute, Sydney, NSW, Australia
  • 8 Department of Psychological Medicine, King's College London, London, UK; Institute of Psychiatry, Psychology, and Neuroscience, and Centre for Society and Mental Health, King's College London, London, UK; South London and Maudsley NHS Trust, London, UK
  • 9 Royal College of Psychiatrists, UK and Faculty of Wellbeing, Education, and Language Studies, Open University, Milton Keynes, UK
  • 10 Harvard TH Chan School of Public Health, Boston, MA, USA
  • 11 American Foundation for Suicide Prevention, New York, NY, USA
  • 12 The William Templeton Foundation for Young People's Mental Health, Cambridge, UK
  • 13 Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
  • 14 Medical Research Council, Swindon, UK
  • 15 The Brookings Institution, Washington, DC, USA
  • 16 York Mental Health and Addictions Research Group, University of York, York, UK
  • 17 WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol Abuse, University of Ibadan, Ibadan, Nigeria
  • 18 Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
  • 19 Swansea University Medical School, Swansea University, Swansea, UK
  • 20 The Alive Again Foundation, Kampala, Uganda
  • 21 Brain & Mind Institute, Aga Khan University, Karachi, Pakistan
  • 22 Bristol Population Health Science Institute, Centre for Academic Mental Health, Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
  • 23 Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
  • 24 United for Global Mental Health, London, UK
  • 25 Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
  • 26 Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA
  • 27 Health Services and Population Research Department, King's College London, London, UK; Centre for Global Mental Health, King's College London, London, UK
  • 28 Edmund A Walsh School of Foreign Service, Georgetown University, Washington, DC, USA
  • 29 Hunter College, Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA
  • 30 Department of Psychological Medicine, King's College London, London, UK
  • 31 Department of Social and Preventive Medicine, Suicide Research & Mental Health Promotion Unit, Center for Public Health, Medical University of Vienna, Vienna, Austria
  • 32 Division of Psychiatry, University College London and Camden and Islington NHS Foundation Trust, London, UK
  • 33 Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
  • 34 University of Rochester Center for the Study and Prevention of Suicide, SafeSide Prevention, Rochester, NY, USA
  • 35 Into The Light Indonesia, Jakarta, Indonesia
  • 36 MQ Mental Health Research, London, UK
  • 37 Department of Psychiatry, Faculty of Medicine and Health Sciences, SAMRC Genomics of Brain Disorders Unit, Stellenbosch University, Cape Town, South Africa
  • 38 Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
  • 39 SNEHA Suicide Prevention Centre, Chennai, India
  • 40 Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region, China
Lancet Psychiatry, 2023 Jun;10(6):452-464.
PMID: 37182526 DOI: 10.1016/S2215-0366(23)00058-5

Abstract

Globally, too many people die prematurely from suicide and the physical comorbidities associated with mental illness and mental distress. The purpose of this Review is to mobilise the translation of evidence into prioritised actions that reduce this inequity. The mental health research charity, MQ Mental Health Research, convened an international panel that used roadmapping methods and review evidence to identify key factors, mechanisms, and solutions for premature mortality across the social-ecological system. We identified 12 key overarching risk factors and mechanisms, with more commonalities than differences across the suicide and physical comorbidities domains. We also identified 18 actionable solutions across three organising principles: the integration of mental and physical health care; the prioritisation of prevention while strengthening treatment; and the optimisation of intervention synergies across social-ecological levels and the intervention cycle. These solutions included accessible, integrated high-quality primary care; early life, workplace, and community-based interventions co-designed by the people they should serve; decriminalisation of suicide and restriction of access to lethal means; stigma reduction; reduction of income, gender, and racial inequality; and increased investment. The time to act is now, to rebuild health-care systems, leverage changes in funding landscapes, and address the effects of stigma, discrimination, marginalisation, gender violence, and victimisation.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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