By: Rhitu Chatterjee

Caption

Digital generated image of cut out male head multilayered with #covid-19 cells inside on blue background.

Even before the federal government's recent decision last week to authorize #COVID-19 boosters all #adults, it had already recommended them in October for people with certain high-risk conditions. Along with with illnesses like diabetes and heart disease, that list included #mentalhealthconditions.

The decision to prioritize people with #psychiatric diagnoses in the early rollout of boosters came after a growing number of studies linked #mentalhealthdisorders with higher risk of both #COVID-19 infection and of serious outcomes.

Last year, researchers analyzed data from five hospitals in the Yale New Haven Health System to see how people with a #mentalhealthdiagnosis who were hospitalized with #COVID-19 fared compared to others.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

"What we found was we had a higher level of mortality for those that had a prior #psychiatric history," says #psychiatrist Dr. Luming Li, who was working on her Master's degree at Yale University at the time.

The risk of death from #COVID-19 went up by 50% for those with a history of #mentalillness compared to those with no such history, says Li, who is now the Chief Medical Officer at the Harris Center for Mental Health and IDD in Texas.

Another study published last year looked at a nationwide database of electronic health records with information on people who'd tested positive for #COVID-19 and those who were hospitalized.

If an individual had a history of a #mentaldisorder, they were more likely to get infected," says study author Dr. Nora Volkow, director of the National Institute on Drug Abuse. "And if they got infected, then they were more likely to have negative outcomes, such as hospitalization and death."

There are several things going on that explain this, she says.

For one, #mentalillnesses change people's #behaviors which can make them less likely to protect themselves from an infection, with measures like #socialdistancing or wearing masks.

Second, people with #mentalillness tend to have poorer overall health and many chronic health problems, like diabetes, cardiovascular problems, kidney disease.

"It is this very high prevalence of comorbid medical conditions that's likely to actually be putting them at greater risk for negative outcomes ," says Volkow.

It's well known that people with #mentalillness on average live shorter lives and die of health conditions other than their psychiatric diagnosis.

"They suffer prematurely from chronic illnesses, medical neglect," says Dr. Ashwin Vasan, who is president and CEO of Fountain House, a #mentalhealth nonprofit.

They are also among the most isolated in society, he says, and that #isolation takes an immense toll on their bodies putting them at a higher risk of chronic illnesses.

"There have been study after study showing that it leads to inflammation, immunologic #stress, neurodegenerative decline, immunologic impairment, endocrinological impairment," says Vasan. It's equivalent to smoking 15 cigarettes a day, he notes.

And many medications used to treat #mentalillnesses, particularly antipsychotics also increase risk of these chronic health problems, says Volkow.

"This has been one of the main challenges that we have with the use of antipsychotics overall, which help control certain symptoms in #schizophrenia but are negatively associated with a much higher risk of diabetes and hypertension and metabolic diseases," she says.

Certainly the risk isn't the same for all #psychiatric diagnoses. It's higher for people with serious #mentalillness, than say mild #depression. But as Vasan pointed out, #mentalillness is not a static thing.

"People's severity of #mentalillness and impairment can ebb and flow depending on the amount of care and support they're getting," he says. "Whether or not you're in the throes of a crisis or managing your chronic #mentalillness, we know on balance, at a population health epidemiologic level, that you're at greater risk."

There's also a clear overlap between serious #mentalillness and #homelessness and substance abuse, which are also linked to high risk of infection and severe #COVID-19.

"About 40% of our chronically homeless population has serious #mentalillness and addiction," says Vasan.

Most of the 13 million people with serious #mentalillness in the US are on Medicaid, he says, but 40% have no access to care at all.

"This is a systematically marginalized, sicker population that has less access to care and supports," he says.

For all these reasons, Vasan and other #mentalhealth experts were glad to see that #CDC prioritized people with #mentalillness for #COVID-19 vaccination, something they say should have happened long before.

But many people with #mentalillness, especially those with serious #mentalillness (people with significant impairments in their daily functioning) may not be aware of their own risks, or the new recommendations, says Li.

It's important for both #healthcareworkers and family members to also be aware of the risks of serious #COVID-19 faced by people with #mentalhealth diagnoses, and help make sure they are vaccinated, says Li.

"It's going to be a very important first step to make sure that they have their vaccines to start out with and then, second, to be able to get the boosters," she says.

Copyright 2021 NPR. To see more, visit https://www.npr.org.
https://standingabovethecrowd.com/?p=8548