During a three-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 is expected. All three modalities of death: accidents, suicide, and natural causes, were higher than that in the population at large. Three suicides were thought to be preventable by psychiatric approaches. The importance of the patient's initial visits was stressed. At least four, and possibly five, cases of death were avoidable by appropriate medico-surgical means. The rate of physical illnesses in all three groups was more than 80%, of which one third were inadequately diagnosed by their referring physicians. The importance of the physical evaluation of psychiatric patients was emphasized.