People With Mental Health Conditions Are at High Risk for COVID-19, So Why Aren’t They Being Prioritized

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People With Mental Health Conditions Are at High Risk for COVID-19, So Why Aren’t They Being Prioritized

Share on PinterestPeople with depression, ADHD and bipolar disorder may be at higher risk for developing COVID-19. Halfpoint Images/Getty ImagesPeople

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People with depression, ADHD and bipolar disorder may be at higher risk for developing COVID-19. Halfpoint Images/Getty Images
  • People with severe mental illness are at higher risk for COVID-19 but are unlikely to be prioritized to receive the coronavirus vaccine.
  • People diagnosed with attention‐deficit/hyperactivity disorder, bipolar disorder, major depressive disorder, or schizophrenia are much more likely to contract the new coronavirus than people without severe mental illness.
  • Experts say these groups should be given priority for a COVID-19 vaccine.

People with severe mental illnesses such as schizophrenia and major depressive disorder have a higher risk of contracting the new coronavirus and dying from COVID-19.

Yet in most countries, this at-risk population is not prioritized to receive the COVID-19 vaccine.

“Society needs to prioritize at-risk groups, but it is dispiriting to see that even during the pandemic, mental health is an afterthought — if that — for many countries,” Hilkka Kärkkäinen, president of the Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN-Europe), said in a news release.

“The scientific evidence is clear that COVID, and the resulting lockdown, is causing significant harm to people with severe mental health problems, but very few countries are addressing this. This needs to change.”

In a new study, Kärkkäinen and her colleagues looked at 20 European countries to see how they prioritized at-risk groups for COVID-19 vaccination.

They found that only Denmark, Germany, the Netherlands, and the United Kingdom recognized severe mental illness as a high-risk medical condition that allows people to be vaccinated earlier.

Their results were published Feb. 17 in the journal Lancet Psychiatry.

It’s a grim statistic that is mirrored by the United States.

Only a few states, such as New Jersey and Ohio, include people with severe mental illness in the early phases of the COVID-19 vaccination rollout. And these were limited to inpatients at psychiatric hospitals.

While many physical medical conditions — such as kidney and heart conditions, obesity, and type 2 diabetes — increase the risk of severe COVID-19, people with severe mental illness are also at higher risk.

Recent research shows that people diagnosed with attention‐deficit/hyperactivity disorder, bipolar disorder, major depressive disorder, or schizophrenia are much more likely to contract the new coronavirus than people without severe mental illness.

Researchers think this may be because people with severe mental illness are more likely to work in unsafe environments, live in overcrowded group settings, or are homeless — all factors that increase their chance of acquiring the virus.

Severe mental illness also increases the risk of dying from COVID-19.

One study in JAMA Network Open found that people with a severe mental illness were one-and-a-half times more likely to die from COVID-19, even after researchers considered other factors such as age and physical medical conditions.

A more recent study in JAMA Psychiatry found that people in New York City with schizophrenia were almost three times more likely to die from COVID-19 than people without schizophrenia. This was after researchers considered other risk factors.

The study’s authors wrote that people with schizophrenia might have differences in their immune systems that predispose them to severe COVID-19.

Or the medications used to treat schizophrenia could worsen COVID-19.

Additional research would be needed to determine whether these factors played a role in patients’ outcomes.

Dr. Benjamin Druss, a professor and Rosalynn Carter Chair in Mental Health at Rollins School of Public Health at Emory University in Georgia, says the New York City study suggests that severe mental illness may increase a person’s risk beyond those other factors.

“People with severe mental illness are definitely at high risk [for COVID-19] due to comorbidities,” he said, “and they may be at even higher risk over and above those comorbidities, as suggested by that article.”

But there are other reasons to prioritize this group for the COVID-19 vaccine.

“People with severe mental illness are also at risk for not getting the vaccine even when they are eligible,” said Druss. He says this is due to “a variety of reasons,” such as higher rates of homelessness and not having regular sources of primary medical care.

He thinks designating this group as a high-risk population should go hand-in-hand with allocating vaccine doses to facilities where people with severe mental illness receive services or healthcare, such as group homes, homeless shelters, community mental health centers, and psychiatric hospitals.

Having a one-dose vaccine approved could help reach this population, since people who receive care or services at these places may not return for a second dose.

“Now, with the Johnson & Johnson vaccine on the horizon, which only requires a single dose, it makes even more sense to expand the range of places that are offering the vaccines to include various kinds of public mental health facilities,” he said.

Though most states do not prioritize people with severe mental illness for the COVID-19 vaccine, people may fall into another priority category based on their age or other medical conditions.

To find out whether you or someone else is eligible to receive the COVID-19 vaccine in your state, check with your state or local health department.

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