Elevated mortality rates among individuals with mental illness have been reported in various studies (1-4). Causes of death, comorbidities, and medical problems of individuals with mental illness also have been assessed (5-7). Although research by McCarrick et al in 1986 highlighted high rates of chronic medical problems among individuals with chronic mental illness (8), very little focus has been placed on interstate comparisons and congruency of mortality and causes of death among public mental health clients. Mortality rates are used as global measures of a population's health status and as indicators for public health efforts and medical treatment. The federal Center for Mental Health Services (CMHS) and the National Association of State Mental Health Program Directors (NASMHPD) have suggested using statewide mortality statistics as outcome measures for public mental health clients (9).
