Successful deinstitutionalization of mental health care: increased life expectancy among people with mental disorders in Finland

To assess impact of deinstitutionalization of mental health care, we studied life expectancy for 341 630 people with hospitalization or early retirement pension for mental disorders in 1981-2003 in Finland. Life expectancy at the age of 15 years was significantly shorter for men/women with serious mental disorder (59.0/70.8 years) than in the general population (75.3/82.1 years) in 2001-03. Life expectancy increased for people with schizophrenia and other psychoses, mood disorders and neurotic disorders, but decreased for people with substance use disorders. Deinstitutionalization and decentralization of mental health services did not affect life expectancy negatively. Policy measures to control adverse effects of alcohol and substance abuse have failed.