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The reduced life expectancy of individuals with serious mental illness (SMI) has been noted since the 1800s (Dembling et al. 1999). Accidental causes were initially thought to explain the mortality gap, with experts focusing on suicide and other violent death as late as 1985 (Black et al. 1985). However, increasing evidence has emerged in the last two decades linking psychiatric and medical illness as the primary cause of excess mortality.
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