Dr Jayati Das-Munshi, lead author and a member of the ARC’s applied informatics research team, said: “People living with severe mental health conditions and intellectual disabilities should be considered a vulnerable group at risk of Covid-19 mortality, as well as deaths from other causes, throughout the pandemic. We suggest a need to prioritise vaccination and optimise physical health care and suicide risk reduction, before, during and after peaks of Covid-19 infection in people living with mental health conditions.”
Through the Clinical Record Interactive System (CRIS) researchers analysed anonymised data from 167,122 patients at South London and Maudsley NHS Foundation Trust on deaths between 2019 and 2020. They assessed mortality ratios across nine mental health conditions and intellectual disabilities and by ethnicity. These were standardised by age and gender and were also compared with five-year average weekly deaths (from 2015 to 2019) from England and Wales. These were then standardised against population data from London, to assess whether estimates were accounted for by local area-level effects.
Senior author Rob Stewart, Professor of Psychiatric Epidemiology & Clinical Informatics at King’s College London and an applied informatics researcher at the ARC, said: “These findings and their implications illustrate the importance of being able to learn from the information contained in health records. We have worked with the Maudsley’s CRIS platform for nearly 15 years now and a key focus has been to highlight inequalities in mortality and general health. Because 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 in those with mental health conditions and intellectual disabilities fell from July 2020 to September 2020 as Covid-19 cases fell and lockdowns eased, however remained double that of the general population which was similar to the figures before the pandemic.
Similar mortality trends were observed across minority ethnic groups within the sample, with South Asian and Black Caribbean people with severe mental health conditions and intellectual disabilities being 2.5 times more likely to die in the pandemic period compared to the year prior to the pandemic. Elevated mortality risks were also evident for White British and Black African people with severe mental health conditions and intellectual disabilities.
Researchers were from the Institute of Psychiatry, Psychology & Neuroscience, the Centre for Implementation Science, and the ESRC Centre for Society and Mental Health, all based at King’s College London.
The study was funded by the NIHR Maudsley Biomedical Research Centre and the Academy of Medical Sciences, and supported by the NIHR Applied Research Collaboration South London.
The paper ‘All-cause and cause-specific mortality in people with mental disorders and intellectual disabilities, before and during the Covid-19 pandemic: cohort study’ was published in The Lancet Regional Health – Europe.