Generated digital image of multilayer ablation male head with covid-19 cells inside on blue background.
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Generated digital image of multilayer ablation male head with covid-19 cells inside on blue background.
Andriy Onufriyenko / Andriy Onufriyenko / Getty
Even before the federal government’s recent decision last week to allow the use of COVID-boosting drugs for all adults, it recommended them in October for people with some of the highest-risk conditions. determined. Along with diseases like diabetes and heart disease, that list includes mental health condition.
The decision to prioritize people with a psychiatric diagnosis in the early stages of the rocket’s deployment comes after a growing body of research links mental health disorders to a higher risk of contracting COVID-19. and serious results.
Last year, researchers analyzed data from five hospitals in the Yale New Haven Health System to see how people with mental health diagnoses hospitalized with COVID-19 compare with others.
“What we discovered was that we had a higher mortality rate for people with a history of mental illness,” said the psychiatrist. Dr. Luming Li, who was doing a Master’s degree at Yale University at the time.
Li, currently the Medical Director at Harris Center for Mental Health and IDD in Texas.
Another study published last year reviewed a national database of electronic health records with information on people who tested positive for COVID-19 and who were hospitalized.
If an individual has a history of mental disorders, they are more likely to be infected,” said the study’s authors. Dr. Nora Volkow, Director of the National Institute on Drug Abuse. “And if they are infected, then they are more likely to have negative outcomes, such as hospitalization and death.”
There’s a number of things going on that explain this, she said.
First, mental illness changes people’s behavior making them less able to protect themselves from infection, by measures like social distancing or wearing a mask.
Second, people with mental illness tend to have poorer overall health and more chronic health problems, such as diabetes, cardiovascular problems, and kidney disease.
“It is the very high prevalence of comorbidities that is likely to actually put them at higher risk for negative outcomes. [from COVID-19],” Volkow said.
It is well known that people with mental illness on average live shorter and die from health conditions other than their mental diagnoses.
“They soon suffer from chronic diseases, suffer from medical neglect,” Dr. Ashwin Vasan is the president and chief executive officer of Fountain House, a mental health nonprofit.
They are also some of the most isolated in society, he said, and that isolation takes a toll on their bodies, putting them at higher risk of chronic diseases.
“There have been studies showing it leads to inflammation, immune stress, neurodegenerative impairment, immunodeficiency, endocrine impairment,” says Vasan. It’s the equivalent of smoking 15 cigarettes a day, he notes.
And many of the drugs used to treat mental illnesses, especially antipsychotics, also increase the risk of these chronic health problems, Volkow said.
“This is one of the main challenges we face with the use of antipsychotics, which help control certain symptoms in schizophrenia but are negatively associated with disease risk,” she said. diabetes, hypertension and metabolic diseases”.
Certainly the risk is not the same for all psychiatric diagnoses. This rate is higher for people with severe mental illness, than for mild depression. But as Vasan pointed out, mental illness is not a static thing.
“The severity of people’s mental illness and impairment can fade and fade depending on the level of care and support they receive,” he said. “Whether you’re in crisis or managing your chronic mental illness, we know the balance, at the population health epidemiology level, that you’re at higher risk.”
There is also a clear overlap between severe mental illness and homelessness and substance abuse, which is also associated with a higher risk of infection and severe COVID-19.
“About 40% of our chronically homeless population suffers from serious mental illness and addiction,” says Vasan.
Most of the 13 million people with serious mental illness in the US are on Medicaid treatment, he said, but 40% are not getting care.
“This is a group of populations that are marginalized, sicker and systematically marginalized, with less access to care and support services,” he said.
For all these reasons, Vasan and other mental health professionals are pleased to see that the CDC has prioritized the COVID-19 vaccine for people with mental illness, which they say should have happened since then. long before that.
But many people with mental illness, especially those with severe mental illness (those with significant impairments in their daily functioning) may not be aware of their own risks, or that the recommendations are made. new proposal, Li said.
It is important for both healthcare workers and family members to also be aware of the serious COVID-19 risks faced by people with a mental health diagnosis and help ensure that, Li said. say they are vaccinated.
“That would be a very important first step to make sure they have the vaccine to start with and then, second, to be able to get the boosters,” she said.
