Mortality among people with mental health problems has increased during the COVID-19 pandemic
The highest number of deaths among people with mental health and developmental disabilities has been magnified during the COVID-19 pandemic, a study based on more than 160,000 patients has found.
Before the pandemic, death rates among people with serious mental health problems were already higher than in the general population. New research published in The Lancet Regional Health – Europe shows that between March and June 2020, during the first wave of COVID-19, mortality increased further among people with mental disorders and intellectual disabilities compared to the general population.
The study was published in the run-up to World Mental Health Day on October 10, 2021, which this year is themed “Mental Health in an Unequal World”.
COVID-19 deaths among people with learning disabilities were nine times higher than in the general population during the first period of lockdown, study finds, and for those with eating disorders almost five times higher. For people with personality disorders and those with dementia, deaths from COVID-19 were about four times higher than in the general population and more than three times higher among people with schizophrenia.
The research was partially funded by the Maudsley Biomedical Research Center (BRC) of the National Institute for Health Research (NIHR) and used the Clinical Record Interactive Search (CRIS) system to analyze anonymized data from clinical electronic records of patients in southern London.
The results of our study paint a startling picture of how the existing vulnerability of people with mental health and developmental disabilities worsened during the COVID-19 pandemic. Higher death rates compared to the general population were associated with more deaths from the COVID-19 infection itself, as well as deaths from other causes. “
Dr Jayati Das-Munshi, lead study author and reader in social and psychiatric epidemiology, King’s College London
Das-Munshi is also Honorary Consultant Psychiatrist with South London and the Maudsley NHS Foundation Trust
“People living with severe mental health problems and intellectual disabilities should be considered a vulnerable group at risk of death from COVID-19, as well as death from other causes, throughout the pandemic. We suggest the need to prioritize vaccination and optimize physical health care and suicide risk reduction, before, during and after peaks of COVID-19 infection in people living with mental health problems. “
Using NIHR Maudsley BRC’s Clinical Records Interactive System (CRIS), researchers analyzed anonymized data from 167,122 patients in South London and the Maudsley NHS Foundation Trust on deaths between 2019 and 2020. They assessed death rates in nine mental health problems and intellectual disabilities and by ethnicity. These were standardized by age and sex and were also compared to the five-year average weekly deaths (2015 to 2019) in England and Wales. These were then standardized against London demographics, in order to assess whether the estimates were captured by the effects at the local area level.
Lead author Rob Stewart, Professor of Psychiatric Epidemiology and Clinical Informatics at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, said: “These findings and their implications illustrate the importance of be able to learn from the information contained in health records. We have been working with Maudsley’s CRIS platform for almost 15 years now and a key goal has been to highlight inequalities in mortality and general health. Since CRIS information is updated on a weekly basis, this has allowed us to track the progress of the COVID-19 pandemic and its impact on mental health services. “
Deaths among people with mental disorders and intellectual disabilities fell from July 2020 to September 2020, as COVID-19 cases declined and lockdowns eased, but remained double those of the general population , which was similar to the figures before the pandemic.
Similar mortality trends were seen among the minority ethnic groups in the sample, with people from South Asia and the black Caribbean with severe mental health and developmental disabilities being 2.5 times more likely to die during the pandemic period compared to the year preceding the pandemic. High mortality risks were also evident for white Britons and black Africans with severe mental health and developmental disabilities.
Das-Munshi, J., et al. (2021) All-cause and specific-cause mortality in people with mental disorders and intellectual disabilities, before and during the COVID-19 pandemic: cohort study. The Lancet. doi.org/10.1016/j.lanepe.2021.100228.