Avoidable mortality in long-stay psychiatric patients of Northern Finland

The aim of the present study was to examine mortality due to avoidable and unavoidable causes, unnatural deaths, and mortality possibly related to the use of psychotropic drugs. Mortality of 253 long-stay psychiatric patients from Northern Finland were monitored over a 9-year period and characterized according to standardized mortality rates (SMRs). Deaths due to avoidable causes included about 30% of all deaths, SMRs being 1.9 times (males) and 3.2 times (females) higher than those of the general population. The risk of unnatural deaths was also elevated, with SMRs amounting to 3.9 in males and 8.5 in females. An increased mortality risk, possibly related to the use of psychotropic drugs, was noticed. The physical care of long-stay psychiatric patients seems not to reach the same level that the general population enjoys. Continuous attention to the physical health of psychiatric patients is important, but new strategies and specific intervention methods should not be neglected. The concept of "avoidable mortality" is a useful, but rarely used indicator of the quality of the medical care in psychiatric populations. However, the concept needs regular updates from the whole field of medicine. From the psychiatric point of view, it was suggested that suicides be regarded as avoidable deaths.