that year. The number of male clients and the number of female clients are determined in each of the 11 age categories mentioned previously for AADRs. The number of clients in each sex–age category is multiplied by the sex–age-specific death rate in that category for each state general population during the same year and then divided by 100,000. The quotients from all the sex–age categories are added to estimate the number of deaths expected per 100,000 public mental health clients during the year. The SMR is calculated by dividing the actual number of client deaths by the expected number of deaths for the year. An SMR of greater than 1.0 indicates that the relative risk of death for mental health clients is higher than that of the general population of the state.
