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RESEARCH WEEKLY: Experiences of People with SMI During the COVID-19 Pandemic
By Shanti Silver
(November 16, 2022) In early 2020, the COVID-19 pandemic upended day-to-day life and caused widespread anxiety, elevated mortality, and economic insecurity for millions of Americans. Compared to the general population, research has shown people with serious mental illness are more likely to die from COVID-19 and were more likely to experience major job loss during the early stages of the COVID-19 pandemic. While the lasting psychological impacts of the COVID-19 pandemic have not yet been established, new research from Psychiatric Services suggests the COVID-19 pandemic may disproportionately impact the long-term mental and physical health of people with serious mental illness.
From July 2020 to January 2021, researchers from Sheppard Pratt in Maryland interviewed people who had a diagnosis of schizophrenia, bipolar disorder, major depression or no psychiatric disorder to explore similarities and differences in COVID-19 related stressors during this time period. Interviews were conducted over telephone or videoconferencing platforms like Zoom.
People with serious mental illness reported higher levels of emotional distress, more missed medical appointments, and increased substance use during the pandemic relative to the general population, according to the results. While the impacts of the pandemic on day-to-day life have subsided in recent months, the authors of this research suggest that the study’s results raise concerns about the long-term impact of the COVID-19 pandemic on people with serious mental illness.
Key Findings
Overall, people with schizophrenia and bipolar disorder expressed more emotional distress because of the pandemic than people with no psychiatric disorders.
People with schizophrenia were more likely than people with no psychiatric disorder to feel:
- overwhelmed by COVID-19,
- worried about medical bills if they were to get sick from COVID-19,
- worried about having enough food because of COVID-19,
- difficulties concentrating because of COVID-19,
- anxious when thinking about COVID-19,
- worried about money because of COVID-19, and
- very worried about getting COVID-19.
People with bipolar disorder were also more likely than people with no psychiatric disorder to feel:
- worried about having enough food because of COVID-19 and
- worried about money because of COVID-19.
People with serious mental illness additionally reported a higher rate of missed medical appointments than people without mental illness. People with bipolar disorder were specifically more likely to report missed medications and problems with accessing medical care.
Compared to people with no mental illness, people with schizophrenia reported significantly increased tobacco smoking since the beginning of the pandemic. The finding that people with schizophrenia had significantly increased tobacco smoking since the beginning of the pandemic is particularly concerning. Tobacco smoking has been shown to be more common among people with schizophrenia than the general population and is a major health concern. According to the CDC, cigarette smoking causes harm to almost every organ, can cause many diseases and lowers life expectancy. Therefore, greater access to smoking cessation programs for people with schizophrenia are increasingly important.
Implications
During the period of data collection, Maryland was no longer in lockdown and was in the process of lifting COVID-19 restrictions. Accordingly, this study’s findings show some of the long-term impacts of COVID-19; impacts that extend beyond the economic uncertainty and social isolation of an acute lockdown.
During this time, people with schizophrenia and bipolar disorder reported higher levels of anxiety about having access to food and money because of COVID-19 compared to the general population. Before the COVID-19 pandemic, people with serious mental illness were already less likely to be employed than the general population. The finding that people with serious mental illness were more worried than the general population about having access to food and money because of COVID-19 may indicate that the pandemic had a disproportionate impact on the economic security of this already vulnerable population. Accordingly, programs that seek to provide employment opportunities and vocational trading to people impacted by COVID-19 may wish to consider giving special consideration to people with serious mental illness.
In addition to the risk of increased smoking, people with serious mental illness were more likely than the general population to have missed medical appointments, despite the widespread availability of telehealth during this time. These missed appointments may pose a risk to the physical and mental health of people with serious mental illness. Further research is needed to determine if this pattern of missed appointments has continued now that appointments have largely returned to being in-person.
References
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