At a glance
- Higher risk of death: People with severe mental illness had a 56% higher risk of dying after COVID-19 infection than those without severe mental illness.
- Vaccination helped, but gaps remained: Despite being prioritised for vaccination, people with severe mental illness continued to face a higher risk of COVID-19-related death throughout the pandemic.
- Health inequalities persist: The findings highlight the need to address the wider factors behind poorer physical health and premature death among people with severe mental illness, beyond vaccination alone.
People with severe mental illness remained at significantly higher risk of death following COVID-19 infection throughout the pandemic, despite being prioritised for vaccination, according to new research published in The Lancet Psychiatry.
Vaccination reduced some risks, but inequalities remained
People with severe mental illness (SMI) have long faced poorer physical health and higher rates of premature death than the wider population. New research has found that this inequality persisted during the COVID-19 pandemic, even after vaccines became available.
Researchers analysed health records from more than 13.5 million people in England who had COVID-19 between January 2020 and June 2023. This included more than 160,000 people with SMI, including schizophrenia, schizoaffective disorder, bipolar disorder and other psychotic disorders.
People with SMI were prioritised for vaccination
People with severe mental illness were prioritised for COVID-19 vaccination from February 2021. By July that year, 73.2% of people with SMI had received two vaccine doses, compared with 67.4% of people without SMI.
However, by June 2023, vaccination coverage among people with SMI was 79.4%, compared with 87.2% among those without SMI.
The researchers found that people with SMI remained at greater risk of death following COVID-19 infection throughout the study period.
Mortality gap remained throughout the pandemic
Across the whole study period, people with SMI had a 56% higher risk of dying from any cause after a COVID-19 infection than people without SMI.
During the period when vaccines were being rolled out, the risk of dying from COVID-19 was 52% higher among people with SMI. Later in the pandemic, this excess risk remained at 25%, even after accounting for vaccination status.
Professor Jayati Das-Munshi, a researcher involved in the study, said:
“People with severe mental illness have long experienced some of the poorest physical health outcomes in society. Our study shows that these inequalities persisted during the COVID-19 pandemic, even after vaccines became available. Prioritising people with severe mental illness for vaccination was an important and effective policy, but more needs to be done to address the wider factors that contribute to poorer health and premature mortality in this population.”
Understanding the wider impact of COVID-19
At MQ Mental Health Research, we have supported research into the mental health and wider health consequences of COVID-19 since the beginning of the pandemic. This has included work investigating the longer-term effects of COVID-19, including its impact on the brain, mental health and wellbeing.
This research adds to the evidence that the pandemic has not affected everyone equally. While prioritising vaccination helped reduce some risks, addressing longstanding health inequalities will require action that goes beyond vaccination.
Understanding why these inequalities persist is an important step towards ensuring that people with severe mental illness are better protected during future public health emergencies.
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