More than 70% of long-term patients in Mississippi’s state-run mental health facilities have received at least one dose of the COVID-19 vaccine, but those in care for the short term have not been a priority.
This is a serious challenge because approximately 25% of the nation’s homeless population, more than 500,000 people, continue to battle severe mental illness.
“We know that states will be monitoring who gets vaccinated, but in our own communities, the people that we take care of, is there a way?” Dr. Jeremiah Rainville, Peer Leadership Council manager for the National Alliance on Mental Illness, or NAMI, asked on Jan. 28, 2021, during a webinar including mental health professionals. “How do we want to think about making sure that no one is left out?”
Adam Moore, communications director for the Mississippi Department of Mental Health, said COVID-19 vaccinations went first to health-care workers. More than 2,084 Department of Mental Health employees received at least the first dose of the COVID-19 vaccine.
But patients admitted to Mississippi State Hospital and East Mississippi State Hospital for short-term care of diagnoses such as suicidal ideation, worsening of psychiatric symptoms, or who were in need of medication adjustments are not vaccinated by the hospitals they reside in during their stay.
Phaedra Cole, executive director of Region 6 Community Health Center in Greenville, Miss., says her center and others have been concerned about getting their clients vaccinated. The majority of adults with serious mental illness also have chronic health conditions, such as cardiovascular disease, diabetes and obesity—all risk factors for worse COVID-19-related outcomes.
Mental Disorders Increase Risk of COVID-19 Infection
A 2020 study found that people with serious mental illness, including schizophrenia, bipolar disorder and major depressive disorder, have a higher mortality rate and shortened life expectancy. This is mainly attributable to physical diseases, particularly cardiovascular diseases. Important risk factors for cardiovascular diseases are especially prevalent in people with serious mental illness, the study found. Several factors contribute to this increased risk, including unhealthy lifestyles and psychotropic medication.
Another NAMI concern was making sure the vaccines were available to mentally ill populations. Cole said many of these individuals live in and/or participate in congregate programs, increasing the risk of exposure.
An analysis in World Psychiatry showed that patients with a recent diagnosis of a mental disorder had a significantly increased risk for COVID‐19 infection, an effect strongest for depression. It involved electronic health records of 61 million adult patients from 360 hospitals and 317,000 providers, across 50 states up to July 29, 2020.
Patients with both a recent diagnosis of a mental disorder and COVID‐19 infection had a death rate of 8.5% compared to 4.7% among COVID‐19 patients with no mental disorder and a hospitalization rate of 27.4% versus 18.6% among COVID‐19 patients with no mental disorder.
“In our campaign to increase participation among our client population, our clinic nurses have conducted workshops to educate our residential and day-program clients about the vaccine,” Cole explained. “Additionally, our staff have assisted clients with scheduling appointments and with transportation as these have been two significant barriers for the population that we serve.”
“Overall, we have been pleased with the response.”
Nonprofit agencies serving marginalized communities are stepping up to help as well. Rex Baker, the center director at Gateway Missions in Jackson, said the Jackson-Hinds Comprehensive Health Center helped vaccinate 13 people there.
“A few refused the vaccine, while some had been vaccinated in other places,” Baker said.
Jill Buckley, executive director of Stewpot Ministries, also in Jackson, said St. Dominic Hospital made the shelter a vaccine center for its clients, staff and other community members including their Opportunity Day Shelter serves.
Ensuring vaccination of staff was also a priority for community health centers. “As with the clients, our nurses provided educational workshops to dispel some of the myths that have lingered about the vaccine,” Cole said. “We also are holding several vaccination raffles in which cash prizes are awarded. Proof of vaccination is all that is needed to participate.”
The educational programs have been effective for both staff and patients. “I just think it’s the right thing to do,” Ariel Veal, the first vaccinated Health Department employee, said. “I didn’t have any doubts about it. I haven’t read anything about what others are saying. I wanted to do it. I want things to get back to normal.”
The United States has seen more than 150 million vaccine shots administered as of April 6, 2021. However, disparity in availability is an issue, especially among non-white populations. That disparity is evident among people with mental illness, too, according to the World Psychiatry analysis.
‘They Should Be Among the Prioritized Groups’
“I think we would all agree that in our communities, people living with mental illness are a vaccine priority group; they are specifically designated as such for those that are living in congregate living facilities, or those that have certain severe medical comorbidities,” said Dr. William Lawson, founder and director of the Maryland-based Institute for Reducing Disparities.
Four countries have updated their vaccination strategies to prioritize patients with severe mental illness—Denmark and the United Kingdom in December 2020, The Netherlands in January 2021 and Germany in February 2021.
“When the evidence shows that people with severe mental illness are at high risk, they should be among the prioritized groups,” Michael E. Benros of the Copenhagen Research Centre for Mental Health in Copenhagen, Denmark, told The Lancet on Feb. 20, 2021.
Mississippi State Hospital and East Mississippi State Hospital Offer Nursing Home Services
- Mississippi State Hospital nursing homes: 173 individuals served, or 92%, have received a first dose of the vaccine.
- East Mississippi State Hospital nursing home: 81 individuals served, or 76%, have received a first dose of the vaccine. The same numbers have received a second dose.
Regional Program Locations for People with Developmental or Intellectual Disabilities
- Boswell Regional Center: 256 individuals, or 75% have received a first dose of the vaccine. 183, or 54%, have received a second dose.
- Hudspeth Regional Center: 231, or 85%, have received a first dose. 227, or 83%, have received a second dose.
- Ellisville State School: 241, or 82%, have received a first dose. 197, or 67%, have received a second dose.
- South Mississippi Regional Center: 111, or 74%, have received a first dose. 85, or 57%, have received a second dose.
- North Mississippi Regional Center: 268, or 73%, have received a first dose. 225, or 61%, have received a second dose.
Source: Mississippi Department of Mental Health
This story was produced in collaboration with the Mississippi Center for Investigative Reporting, a nonprofit news organization that seeks to inform, educate and empower Mississippians in their communities through the use of investigative journalism. Sign up for their newsletter.