I went to a funeral of a friend today. He was 53 years old and died of pneumonia. He also suffered from a chronic, severe mental illness. His death was an avoidable tragedy in more than one way.

He was certainly a poster child for the federal study released two years ago that announced that individuals with severe and persistent mental illnesses tend to die 25 years earlier than those without the illnesses.

That fact is one of the most significant tragedies associated with my friend's death because it is indictment of the nation's and Maryland's health system. Integration of behavioral and somatic health happens rarely in our country and that is a signficant problem and that is why so many people with severe mental illnesses die so young.

I actually have colleagues who express caution in rushing to integrate the care, fearing that mental health care will get short shrift in an integrated system. Mental health care has gotten short shrift in a fragmented system! Come on! People are dying.

My friend actually got better mental health care than most in this country. He lived in a group residence with 24 hour support. He had a good medical daycare program to go to five days a week. He had case management support and access to clinical care.

Would that he had regular access to primary care instead of having to go to the emergency room repeatedly when his COPD became problematic.

My colleagues need to get over their paranoia and push for a system of integrated care for individuals like my friend. Twenty-five years is a crime!