Health Conditions Associated With Severe Illness From COVID-19 Among Individuals With Serious Mental Illness

Back to table of contents Previous article Next article DatapointsFull AccessHealth Conditions Associated With Severe Illness From COVID-19 Among Individuals With Serious Mental IllnessPriscilla Novak, Ph.D., Maria X. Sanmartin, Ph.D., Mir M. Ali, Ph.D., Jie Chen, Ph.D.Priscilla NovakSearch for more papers by this author, Ph.D., Maria X. SanmartinSearch for more papers by this author, Ph.D., Mir M. AliSearch for more papers by this author, Ph.D., Jie ChenSearch for more papers by this author, Ph.D.Published Online:19 Nov 2020https://doi.org/10.1176/appi.ps.202000300AboutSectionsView articleSupplemental MaterialPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleIndividuals with serious mental illness have more chronic medical conditions that increase their risk for contracting severe COVID-19 compared with individuals without serious mental illness and are more likely to be distinctly affected by the pandemic. For example, individuals with serious mental illness may face increased difficulties taking time off work and may experience health system–level barriers to testing and treatment (1). Furthermore, social isolation due to physical distancing requirements may exacerbate their mental illness (2).A recent study has reported that comorbid health conditions such as obesity, hypertension, and diabetes are highly prevalent among patients hospitalized with COVID-19 (3). According to guidance from the Centers for Disease Control and Prevention (CDC) as of October 2020 (4), people with asthma, obesity, hypertension, bronchitis, heart conditions, diabetes, kidney disease, liver disease, and compromised immune systems (i.e., current smokers or individuals undergoing cancer treatment) are or might be at an increased risk for severe illness from COVID-19 compared with individuals without these conditions.Using survey-weighted data from the 2015–2018 National Survey on Drug Use and Health, a nationally representative sample of noninstitutionalized nonhomeless respondents (N=226,600), we found that individuals with serious mental illness (N=9,700, weighted N=10.8 million) have higher prevalence of most of the health conditions associated with severe COVID-19 compared with individuals without serious mental illness (N=216,900, weighted N=260 million) (Figure 1). Specifically, among individuals with serious mental illness, the rate of asthma was 19% (N=1,843); of bronchitis, 11% (N=1,067); of nicotine dependence, 21% (N=2,037); and of obesity, 46% (N=4,462). Statistical significance was designated a priori at p≤0.05; all differences in the rates of medical conditions were statistically significant in the nonstratified sample (see online supplement). To address the greater risk for more severe COVID-19 among people age 65 or older, we stratified the estimates by age and found higher rates of all the CDC-identified conditions, except for cancer, among those ages ≥65 and having serious mental illness than among those ages ≥65 without serious mental illness.FIGURE 1. Underlying medical conditions of individuals with and without serious mental illnessaaThe Ns for the percentages shown here are in Appendix Table 1 of the online supplement.Our findings suggest that significant health conditions are prevalent among individuals with serious mental illness, which may increase their risk for experiencing severe COVID-19. As states have declared emergencies because of COVID-19, many routine services previously available to patients with serious mental illness have been limited, refocused, or closed (5). Ongoing efforts appear to be warranted to ensure that services remain available to individuals with serious mental illness during this pandemic.Department of Health Policy and Management, University of Maryland, College Park (Novak, Ali, Chen); Department of Health Professions, Hofstra University, Hempstead, New York (Sanmartin). Tami L. Mark, Ph.D., and Alexander J. Cowell, Ph.D., are editors of this column.Send correspondence to Dr. Novak ([email protected]).The authors report no financial relationships with commercial interests.References1 Druss BG: Addressing the COVID-19 pandemic in populations with serious mental illness. JAMA Psychiatry 2020. doi: 10.1001/jamapsychiatry.2020.0894Crossref, Medline, Google Scholar2 Xiang YT, Jin Y, Cheung T: Joint international collaboration to combat mental health challenges during the coronavirus disease 2019 pandemic. JAMA Psychiatry 2020. doi: 10.1001/jamapsychiatry.2020.1057Crossref, Google Scholar3 Richardson S, Hirsch JS, Narasimhan M, et al.: Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020. doi: 10.1001/jama.2020.6775Crossref, Google Scholar4 People with Certain Medical Conditions. Atlanta, Centers for Disease Control and Prevention, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/groups-at-higher-risk.html. Accessed Oct 21, 2020Google Scholar5 Li L: Challenges and priorities in responding to COVID-19 in inpatient psychiatry. Psychiatr Serv 2020; 71:624–626Link, Google Scholar FiguresReferencesCited byDetailsCited byAttitudes Toward COVID-19 Vaccination Among Behavioral Health Service ClientsLexie R. Grove, Ph.D., M.S.P.H., Kaleigh R. Emerson, M.P.H., M.S.S.W., Laura Stevens Merola, M.Ed., L.P.C., Spencer Andries, B.S., Deborah Ann Cohen, Ph.D., M.S.W.18 July 2023 | Psychiatric Services, Vol. 74, No. 12COVID-19-Related Outcomes Among Group Home Residents with Serious Mental Illness in Massachusetts in the First Year of the Pandemic8 November 2023 | Administration and Policy in Mental Health and Mental Health Services Research, Vol. 36National trends in psychotropic medication prescribing before and during the COVID-19 pandemicPsychiatry Research, Vol. 325Mitigating COVID-19 Risk and Vaccine Hesitancy Among Underserved African American and Latinx Individuals with Mental Illness Through Mental Health Therapist–Facilitated Discussions9 May 2022 | Journal of Racial and Ethnic Health Disparities, Vol. 10, No. 3Serious Mental Illness Diagnosis and COVID-19 Vaccine Uptake in the Veterans Health AdministrationTaona P. Haderlein, Ph.D., M.A., W. Neil Steers, Ph.D., Aram Dobalian, Ph.D., J.D.18 January 2022 | Psychiatric Services, Vol. 73, No. 8The Association Between History of Depression and Access to Care Among Medicare Beneficiaries During the COVID-19 Pandemic17 August 2021 | Journal of General Internal Medicine, Vol. 36, No. 12COVID-19-related psychological distress and engagement in preventative behaviors among individuals with severe mental illnesses3 February 2021 | npj Schizophrenia, Vol. 7, No. 1 Volume 72Issue 4 April 01, 2021Pages 468-469 Metrics KeywordsSerious mental illnessCoronavirusComorbid conditionsCOVID-19PDF download History Received 30 April 2020 Revised 22 June 2020 Accepted 17 July 2020 Published online 19 November 2020 Published in print 1 April 2021