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

Rory C O'Connor, Carol M Worthman, Marie Abanga, Nikoletta Athanassopoulou, Niall Boyce, Lai Fong Chan, Helen Christensen, Jayati Das-Munshi, James Downs, Karestan C Koenen, Christine Yu Moutier, Peter Templeton, Philip Batterham, Karen Brakspear, Richard G Frank, Simon Gilbody, Oye Gureje, David Henderson, Ann John, Wilbroad KabagambeMurad Khan, David S Kessler, Olivia J Kirtley, Sarah Kline, Brandon Kohrt, Alisa K Lincoln, Crick Lund, Emily Mendenhall, Regina Miranda, Valeria Mondelli, Thomas Niederkrotenthaler, David Osborn, Jane Pirkis, Anthony R Pisani, Benny Prawira, Hala Rachidi, Soraya Seedat, Dan Siskind, Lakshmi Vijayakumar, Paul S F Yip

Research output: Contribution to journalReview article (Academic Journal)peer-review

22 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)452-464
Number of pages13
JournalLancet Psychiatry
Issue number6
Early online date11 May 2023
Publication statusPublished - 1 Jun 2023

Bibliographical note

Funding Information:
MQ Mental Health Research and The William Templeton Foundation for Young People's Mental Health co-funded the road mapping exercise. MQ co-led the work and provided administrative support, also appointing IfM Engage to help facilitate the workshop process. Many thanks to Sarah Shenow for guiding the early phase of the Gone Too Soon initiative on behalf of MQ Mental Health Research.

Publisher Copyright:
© 2023 Elsevier Ltd


  • Humans
  • Mortality, Premature
  • Mental Disorders/therapy
  • Mental Health
  • Suicide
  • Delivery of Health Care


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