During a 3 year period 28 fatalities, twice the rate in the general population, were found in a sample of 2,070 psychiatric outpatients. Death occurred in these psychiatric patients approximately 20 years earlier than expected. All 3 modalities of death: accidents, suicide, & natural causes, were higher that in the population at large. 3 suicides were thought to be preventable by psychiatric approaches. The importance of the physical evaluation of psychiatric patients was emphasized.