Researchers from the Centre for Addictions and Mental Health in Toronto have found that people with schizophrenia are at an increased risk of adverse outcomes related to COVID-19, compared to the general population.
These disproportionate harms are related to several risk factors for people with schizophrenia, including:
- Poor outcomes resulting from COVID-19 infection, as people with schizophrenia experience poorer physical health than their healthy peers and are overrepresented among vulnerable populations.
- Poor mental health outcomes for people with schizophrenia due to isolation, stigma, and discrimination worsened by COVID-19.
- Impacts on mental health service delivery due to disrupted medical care as a result of the COVID-19 pandemic.
Physical health
Certain populations are at increased risk of COVID-19 infection, including people who are incarcerated or homeless. People with schizophrenia are overrepresented among such populations for whom social distancing and protective measures are not possible.
Additionally, people with schizophrenia are at increased risk of physical conditions, including cardiovascular disease, diabetes, and chronic respiratory disease. These conditions make them more vulnerable to serious harm resulting from a COVID-19 infection.
Mental health and isolation
Social support and community support are important for those with schizophrenia, but social distancing measures designed to slow the spread of COVID-19 have left many people isolated. This loneliness and isolation put people with schizophrenia at increased risk of serious distress and even suicide.
Mental health services
Research from China and South Korea has found that individuals in inpatient mental health units are vulnerable to COVID-19, which can spread in confined settings.
Those who rely on outpatient care may also see serious disruptions in their care, as COVID-19 has led many health providers to make abrupt changes to how they deliver treatment. Interruptions or delays in treatment put people with schizophrenia at increased risk.
Recommendations
The researchers made several recommendations to protect the health of people with schizophrenia, including:
- Addressing the social determinants of health that affect people with schizophrenia, including the need for safe housing
- Maintaining social networks for people with schizophrenia through safe and socially distant methods, like video conferencing with family and friends
- Continuing services that address basic needs (e.g. income, food) without interruption
- Ensuring social distancing and rapid isolation for individuals with COVID-19 symptoms in inpatient and healthcare settings
- Adopting telehealth and digital healthcare models for outpatient mental health care
- Using remote assessments and delivery methods to permit research studies to continue safely