RESEARCH WEEKLY: June Research Roundup
By Elizabeth Sinclair Hancq
Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments. This month’s roundup is focused on new research on how the COVID-19 pandemic has impacted people with serious mental illness.
DATAPOINT of the month
3.5-fold increase in psychological distress due to COVID-19
Almost 14% of Americans reported symptoms of serious psychological distress in April 2020 during the peak of the coronavirus pandemic, according to new research from Johns Hopkins University. This represents a 3.5-fold increase compared to the same time period in 2018 when only 3.9% of Americans reported these symptoms. Serious psychological distress is not severe mental illness, but rather is a measurable research construct defined as mental health problems severe enough to cause moderate to severe impairment. However, the results indicate there will be a growing mental health treatment need in this country, which has significant implications for over-burdening an already strained mental health treatment system in the United States.
RESEARCH of the month
High transmission of COVID-19 in state psychiatric hospitals
State psychiatric hospitals, like nursing homes, are at an increased risk of spread of COVID-19 due to their institutional setting. As we wrote in April, precautions should be taken to safeguard patients in psychiatric hospitals to protect these individuals.
One of the first epidemiologic studies analyzing COVID-19 spread in a state psychiatric hospital was published earlier this month in Psychiatric Services. The study found that nearly 78% of patients from the building with the hospital’s initial case eventually tested positive for COVID-19. Although the authors report that the hospital followed the initial CDC recommendations for preventing transmission of the virus, further action, such as universal masking, was needed to contain the spread.
Almost 90% of the asymptomatic patients tested positive for the virus, indicating that asymptomatic spread was common in the hospital building, according to the study findings. While it is fortunate that many of the patients were not critically ill due to COVID-19 infection, the asymptomatic patients made containing the spread of the virus more challenging.
Improving care for people with serious mental illness in community settings during COVID-19
Providing care to people with serious mental illness in the community during the COVID-19 pandemic has been extremely challenging due to the precautions put in place to reduce community spread of the virus.
In a research article published earlier this month in Community Mental Health Journal, study authors argue that some of the adaptations to care delivery that have been adopted due to COVID-19 should be maintained.
Specifically, the authors highlight the benefits of greater integration of physical and mental health care, the importance of clozapine and antipsychotic injection maintenance and broadening telehealth approaches. The authors suggest that some of the changes to clinical practice in community mental health centers as a result of COVID-19 can align with research-driven best practices if implemented properly.
Implications of COVID-19 for people with schizophrenia
As we wrote back in March, the COVID-19 pandemic has the potential to have outsized impacts on vulnerable populations, including those with severe mental illness. According to a new paper published in Schizophrenia Bulletin in April, researchers expect the COVID-19 global pandemic to further exacerbate the health and economic disparities experienced by people with schizophrenia.
In the article, the authors suggest that there is an increased risk for infection in people with schizophrenia due to difficulties adhering to infection control measures, both in understanding the risk and as well as due to living in congregate settings making distancing challenging. Individuals with schizophrenia are also more likely to have poorer outcomes if infected due to the high prevalence of smoking and co-morbid physical health conditions.
The researchers also argue that people with schizophrenia are at higher risk to experience negative mental health outcomes, including having increased stress, loneliness and fear. Importantly, the authors highlight how the precautions being taken to reduce risk among vulnerable populations have put recruitment for clinical trials on hold and reduced in-person research, adversely affecting research into schizophrenia more than other types of illnesses.
