How will Mississippi ensure those battling mental illness are getting the COVID vaccine?
Mental health advocates are raising concerns about how to ensure people with mental illness receive the COVID-19 vaccine. Shutterstock
By Julie Whitehead
Mississippi Center for Investigative Reporting
Vaccines for Mississippi’s health care workers? Check.
Vaccines for those hospitalized long term? Check.
Vaccines for the short-term mentally ill? Maybe.
More than 70% of the 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 for the short term aren’t on the priority list.
Getting those served by the community mental health centers represents a serious challenge because up to a fourth of the nation’s more than a half million homeless 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 Virginia-National Alliance on Mental Illness, asked on a webinar that included mental health professionals. “How do we want to think about making sure that no one is left out?”
Adam Moore, communications director for the state Department of Mental Health, said the COVID-19 vaccinations went first to health care workers. More than 2,084 Department of Mental Health employees had 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 in need of medication adjustments are not vaccinated by the hospitals they reside in during their stay.
Mississippi State Hospital and East Mississippi State Hospital offer nursing home services. Vaccinations delivered:
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.
Source: Mississippi Department of Mental Health
Phaedra Cole, executive director of Region 6 Community Health Center in Greenville, says her center and others have been very concerned about getting their clients vaccinated, as 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.
A study last year found that people with serious mental illness, including schizophrenia, bipolar disorder and major depressive disorder, have a higher mortality rate and shortened life expectancy, mainly attributable to physical diseases, particularly cardiovascular diseases. Important risk factors for cardiovascular diseases are especially prevalent in people with serious mental illness, according to the study. Several factors contribute to this increased risk, including unhealthy lifestyles and psychotropic medication.
Another NAMI concern about vaccinations for the mentally ill was making sure the vaccines were available to those populations.
Cole said many of these individuals live in and/or participate in congregate programs, increasing the risk of exposure.
Regional program locations for people with developmental or intellectual disabilities and the vaccinations delivered there:
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
An analysis in World Psychiatry found 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% vs. 4.7% among COVID‐19 patients with no mental disorder and a hospitalization rate of 27.4% vs. 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.”
“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,” Cole said. “Overall, we have been pleased with the response.”
Nonprofit agencies that serve marginalized communities are stepping up to help as well. Thirteen people were vaccinated at Gateway Missions through the Jackson-Hinds Comprehensive Health Center, according to Rex Backer, center director.
“A few refused the vaccine while some had been vaccinated in other places,” Baker said.
Jill Buckley, executive director of Stewpot Ministries, said St. Dominic Hospital made it a vaccine center for its clients, staff and other community members including those served by their Opportunity Day Shelter.
Making sure staff were vaccinated 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. The first Health Department employee who got the shot, Ariel Veal, noted, “I just think it’s the right thing to do. 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.”
More than 140 million vaccine shots for COVD-19 have been given in the United States. Disparity in availability, however, has emerged, especially among minorities. That disparity is evident among minorities with mental illness, too, according to the analysis in World Psychiatry.
“I think we would all agree that in our communities of 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 LLC.
Four countries have updated their vaccination strategies to prioritize patients with severe mental illness – Denmark and the United Kingdom in December, The Netherlands in January and Germany in February.
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.
This story was produced by 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 our newsletter. Email Julie Whitehead at julie.whitehead.mcir@gmail.com.