We compared leading causes of death for public mental health clients and the statewide population for the six states that provided data about causes of death. The leading causes of death for public mental health clients were compiled for each state during each year using categories from CDC publications so that comparisons with CDC could be made (11-18,22). Natural causes and external causes, such as accidents and suicide, were included. Differences in accident and suicide rates between people with mental illness and general populations of states have been found in previous analyses (23).