Individuals with serious mental illness (SMI) experience a 10- to 25-year reduced life expectancy compared with the general population. Early mortality for people with SMI has mainly been attributed to unhealthy behaviors (e.g., poor diet, sedentary lifestyle), which has led to the development of health promotion and self-management interventions specifically for people with SMI to promote health behavior change. Yet after decades of research, the mortality gap between people with SMI and the general population is increasing. To address this early mortality disparity for individuals with SMI, a new paradigm must be explored. In this article, we present the social processes impacting early mortality in people with SMI paradigm, which highlights the powerful role of social processes in shaping the health and health behaviors of people with SMI. This paradigm explores how loneliness, stigma (social and self), trauma, social exclusion, social isolation, and social norms are related to early mortality in people with SMI. This new paradigm is an important step in understanding and potentially addressing early mortality in people with SMI.

与普通人群相比，患有严重精神疾病 (SMI) 的人的预期寿命缩短了 10 至 25 年。SMI 患者的早期死亡率主要归因于不健康的行为（如不良饮食、久坐不动的生活方式），这导致了专门针对 SMI 患者的健康促进和自我管理干预措施的发展，以促进健康行为的改变。然而，经过数十年的研究，SMI 患者与普通人群之间的死亡率差距正在扩大。为了解决 SMI 患者的这种早期死亡率差异，必须探索一种新的范式。在本文中，我们介绍了影响 SMI 患者早期死亡率的社会过程范式，强调了社会过程在塑造 SMI 患者的健康和健康行为方面的强大作用。该范式探讨了孤独感、污名（社会和自我）、创伤、社会排斥、社会孤立和社会规范与 SMI 患者的早期死亡率之间的关系。这种新的范式是理解和可能解决 SMI 患者早期死亡率的重要一步。