Mental Illness & Chest Pain: Care Gaps After the 911 Call

What This Study Is About

People living with severe mental illness (SMI) — such as schizophrenia or bipolar disorder — are known to have higher rates of heart disease. But what happens when they call emergency services with chest pain? This Danish study looked at whether the emergency system treats them fairly.

What Researchers Did

Scientists studied over 64,900 chest pain emergency calls made in Copenhagen between 2014 and 2018. About 4,300 of those calls (7%) came from people with severe mental illness. They compared what happened to both groups — from the initial phone triage all the way through hospital treatment.

Key Findings

• Ambulance dispatch: People with SMI were actually more likely to receive an emergency ambulance (66% vs 63%).
• Hospital admission: Despite this, they were less likely to be admitted to hospital within 24 hours (81% vs 85%).
• Heart disease diagnosis: Once admitted, they were significantly less likely to be diagnosed with a cardiovascular condition (16% vs 26%).
• Treatment: They were also less likely to receive heart-opening procedures (revascularization) within 30 days (4% vs 7%).
• Survival: 30-day mortality was similar in both groups (around 1–2%).

Why This Matters for Diabetes Patients

Diabetes and severe mental illness often occur together, and both raise the risk of heart disease. People managing both conditions may face extra hurdles getting proper cardiac care when it matters most — including during a chest pain emergency. Being aware of these gaps can help patients and caregivers advocate more effectively in emergency situations.

What the Researchers Concluded

The problem is not at the point of dispatching an ambulance — people with SMI are actually prioritised there. The gap opens up after the call, during hospitalisation, diagnosis, and treatment. Researchers suggest that chest pain may present differently in people with SMI, making it harder for doctors to recognise a heart problem. Better tools are needed to identify who is truly at cardiac risk.