Date of Conferral

2020

Degree

Ph.D.

School

Public Health

Advisor

Mary L. Gutierrez

Abstract

Individuals with mental illness experience increased mortality and premature death. In a sample composed of 88% decedents with mental illness who were Black, the findings from three research studies provided insight about excess and premature mortality, odds of dying by cause of death, and risk factors associated with premature mortality. The purpose of this quantitative study was to examine the mortality of a population group with mental illness that was served in a public mental health system (PMHS). The ecoepidemiological life course framework for health, disease, and mortality was used to link mechanisms that may influence health and longevity in space and time among this population group. From 2010 to 2014, 22,668 deaths occurred in the general population, 5% of which were from individuals who were served in the PMHS. Using the indirect standardization method it was found that people with mental illness served in the PMHS experienced excess mortality (SMR = 1.78). Persons with mental illness also experienced premature death (YPLL = 23 years). Risk of dying due to unnatural causes of death by unintentional injury or accidents (OR = 2.46) was associated with mental illness. Using multiple regression four predictive risk factors accounted for 15% of the variance in premature mortality among people with mental illness served in the PMHS: being female, Black, never married, and tobacco user. Persons served in the PMHS continue to be affected by their mental illness. The greatest impact of experiencing mental illness is loss in life expectancy. Findings may encourage solutions to decrease the mortality due to accidents among people with mental illness. This may prolong the longevity of this population group, and may improve the overall health status of the general population.

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