Briefing: Premature Deaths Among People with Severe Mental Illness in Manchester
Overview
Recent national data reveal a deepening health crisis for people living with severe mental illness (SMI) in Greater Manchester. Between 2021 and 2023, Manchester recorded the highest rate of premature deaths among people with SMI anywhere in England.
According to analysis reported by the Manchester Evening News (Helena Vesty & Richard Ault, 23 Jan 2025):
233 deaths per 100,000 people with SMI were recorded in Manchester.
This means people with long-term mental health conditions were more than twice as likely to die early as the national average (England = 111 deaths per 100,000).
Manchester’s rate was higher than other northern localities with severe deprivation such as Blackpool (232), Middlesbrough (213), and Liverpool (196).
The lowest rate, in Oxfordshire, was 55 per 100,000 – four times lower than Manchester’s.
Across England, over 130,000 adults with SMI died prematurely between 2021 and 2023 — around 18,000 more than in 2017–2019, before the COVID-19 pandemic.
Causes and Contributing Factors
Physical illness, not mental illness itself, is the main cause of early deaths among people with SMI — including cancers, heart, liver, and respiratory disease.
People with SMI typically die 15–20 years earlier than the general population.
Contributing factors include:
• High smoking and obesity rate
• Poor management of chronic physical conditions
• Barriers to accessing preventive and primary care
• Fragmented mental and physical health pathways
Local Inequalities
Manchester remains one of England’s most deprived local authorities:
Ranked 6th most deprived nationally
41 % of children under 16 live in poverty
Life expectancy: Men 74 years / Women 79 years (≈ 5 years below national average)
Social determinants — low income, insecure work, poor housing, pollution, and limited transport connectivity — are all driving worse health outcomes. Poverty and chronic stress contribute both to mental illness and the physical conditions that cause early death.
Systemic Failures in Mental Health Services
The mortality data coincide with a prolonged crisis in Greater Manchester’s mental health system:
Greater Manchester Mental Health NHS Foundation Trust (GMMH)
Rated Inadequate by the CQC in 2023
Issued a formal warning notice (June 2024) citing failures in governance, ligature and fire safety, infection control, and staff training
Premature Deaths Among People with Severe Mental Illness in Manchester
Pennine Care NHS Foundation Trust remains “Requires Improvement” (2019 rating)
The pandemic and cost-of-living crisis have intensified demand, while workforce shortages and service fragmentation persist.
Despite multiple reviews and recovery plans, there is no clear evidence of a sustained improvement in safety or outcomes.
Wider Health System Response
A spokesperson for NHS Greater Manchester stated in 2025:
“We will look closely at the latest data to understand if there was anything that could have been done differently, which we will feed into our current programmes of work… including a focus on the physical healthcare of those with severe mental illness.”
This statement underscores a reactive posture — acknowledging disparities but not yet matching the scale of the challenge.
Policy Implications
Public Health Emergency:
The mortality gap for people with SMI in Manchester represents an urgent equity issue requiring city-region-wide action.
Accountability: Scrutiny bodies should evaluate whether GMMH’s current leadership and governance structures are fit to deliver sustained improvement.
Integrated Care: Physical and mental health strategies must be joined up across NHS GM, local authorities, and voluntary sectors.
Deprivation Strategy: Tackling poverty, housing, and employment precarity is essential to reducing early deaths.
Independent Inquiry: Given the persistent failures, there is a strong case for a statutory inquiry into mental health-related deaths and system safety in Greater Manchester.
Action
1. Manchester now has the highest premature mortality rate for people with severe mental illness in England.
2. Deaths are largely preventable, driven by physical illness, poverty, and systemic neglect.
3. Four Greater Manchester boroughs — Manchester, Salford, Bury, and Rochdale — are all in the national top ten for highest rates.
4. Service failures and deprivation are compounding factors, not isolated issues.
5. Urgent, coordinated action is needed — across health, housing, and social policy — to prevent further avoidable deaths.d
