The Impacts of COVID-19 on a Statewide Population With Mental Illness

Uptake of COVID-19 vaccination among community-dwelling individuals receiving healthcare for substance use disorder and major mental illness: a matched retrospective cohort study

Introduction

Patients with major mental illness (MMI) and substance use disorders (SUD) face barriers in accessing healthcare. In this population-based retrospective cohort study, we investigated the uptake of COVID-19 vaccination in Ontario, Canada among community-dwelling individuals receiving healthcare for major mental illness (MMI) and/or substance use disorders (SUD), comparing them to matched general population controls.

Methods

Using linked health administrative data, we identified 337,290 individuals receiving healthcare for MMI and/or SUD as of 14 December 2020, matched by age, sex, and residential geography to controls without such healthcare. Follow-up extended until 31 December 2022 to document vaccination events.

Results

Overall, individuals receiving healthcare for MMI and/or SUD (N = 337,290) had a slightly lower uptake of first (cumulative incidence 82.45% vs. 86.44%; hazard ratio [HR] 0.83 [95% CI 0.82-0.83]) and second dose (78.82% vs. 84.93%; HR 0.77 [95% CI 0.77-0.78]) compared to matched controls. Individuals receiving healthcare for MMI only (n = 146,399) had a similar uptake of first (87.96% vs. 87.59%; HR 0.97 [95% CI 0.96-0.98]) and second dose (86.09% vs. 86.05%, HR 0.94 [95% CI 0.93-0.95]). By contrast, individuals receiving healthcare for SUD only (n = 156,785) or MMI and SUD (n = 34,106) had significantly lower uptake of the first (SUD 78.14% vs. 85.74%; HR 0.73 [95% CI 0.72-0.73]; MMI & SUD 78.43% vs. 84.74%; HR 0.76 [95% CI 0.75-0.77]) and second doses (SUD 73.12% vs. 84.17%; HR 0.66 [95% CI 0.65-0.66]; MMI & SUD 73.48% vs. 82.93%; HR 0.68 [95% CI 0.67-0.69]).

Discussion

These findings suggest that effective strategies to increase vaccination uptake for future COVID-19 and other emerging infectious diseases among community-dwelling people with SUD are needed.

COVID-19 coping experiences of individuals with schizophrenia: A grounded theory approach in Korea

Humankind has responded to the profound medical, economic, social, and cultural consequences of coronavirus disease 2019 (COVID-19) by employing various strategies. However, although individuals with mental disorders, including schizophrenia, have suffered more challenges from the infectious disease spread, they have received inadequate attention and care. Hence, this study aimed to explore the experiences of individuals with schizophrenia coping with COVID-19; one-to-one interviews were conducted with 17 individuals diagnosed with schizophrenia in Korea. The data were analysed using grounded theory methodology. The results showed that individuals with schizophrenia became distanced from the routine care they received before COVID-19, faced a dual threat from their mental illness and the emerging infectious disease, and experienced inequity and paradoxical situations. Nevertheless, they strived to live their daily lives by utilizing non-face-to-face access, seeking support from mental health professionals, and devising self-help measures. Moreover, reflecting on their lives throughout the pandemic after returning to their regular daily lives provided an opportunity for healing and growth. This study's results can provide evidence for treating individuals with schizophrenia and other mental disorders during subsequent infectious disease spread. Practical policies and interventions tailored to their vulnerabilities are required.

Loneliness in Young Adults During the First Wave of COVID-19 Lockdown: Results From the Multicentric COMET Study

The COVID-19 pandemic has affected the mental and physical health of the general population at any age, but it is expected to have a protracted and severe consequences for younger populations. The pandemic has had several consequences on mental health including anger and irritability, depressive symptoms and somatic complaints, insomnia, lack of motivation, and loneliness. In particular, loneliness and its related negative feelings are thought to be particularly pronounced during young adulthood because of the many social changes that young people deal with during this period of life. Therefore, it is essential to evaluate the type of impact of the pandemic on the mental health of young people and their levels of loneliness experienced during the first phase of the lockdown. Based on the largest Italian study on the effects of the COVID-19 pandemic on the mental health of general population, in this paper we aim to: (1) describe the levels of loneliness in a national sample of Italian young adults aged 18-34 years, during the first wave of lockdown in 2020; (2) evaluate the clinical and socio-demographic differences in young adults reporting low vs. high levels of loneliness; (3) assess the role of clinical symptomatology, coping strategies, levels of resilience, and duration of lockdown as possible predictors of loneliness. The final sample consists of 8,584 people, mainly female (72.6%), single, with a mean age of 26.4 (±4.4) years. The mean score at the UCLA was 47.5 (±13.6), with 27% (N = 2,311) of respondents exceeding the cut-off for high levels of loneliness. High levels of loneliness were predicted by the presence of avoidant coping strategies, such as self-distraction (Beta coefficient, B = 0.369, 95% Confidence Interval, CI = 0.328-0.411), venting (B = 0.245, 95% CI = 0.197-0.293), denial (B = 0.110, 95% CI = 0.061-0.159), and emotional disengagement (B = 0.133, 95% CI = 0.080-0.185). Weeks of exposure to the pandemic were significantly associated with worsening of loneliness (p < 0.000). There is currently considerable interest in trying to reduce loneliness, both within the context of COVID-19 and more generally. Our results highlight that young people are at a higher risk of developing loneliness and suggest that more interventions and practical guidelines are needed.