All eight states did not submit data for all years, which may influence the generalizations of our study findings. Future similar analyses with additional data will increase the generalizability of our findings. Regardless, a review of the findings in this study raises the issue of determining what can be done to lower the mortality rates and risk of early death for people with mental illness, especially people with the most serious diagnoses. Twenty years ago, McCarrick et al reported higher rates of chronic medical problems among people with chronic mental illness, and chronic illness is known to increase risk of death. They suggested in their conclusions that "psychiatrists need to be adept at caring for physical illness, and primary-care physicians need to acquire skills in caring for the mentally ill" (8).
