Adults with severe mental illnesses such as schizophrenia and bipolar disorder are being urged to come forward for their Covid-19 vaccination.
The group was added to vaccine priority group six earlier this year, alongside people with learning disabilities.
In a blog post published this week, Dr Nikki Kanani, medical director of primary care for NHS England and NHS Improvement, and NHS England’s national mental health director Claire Murdoch, urged those with severe mental illnesses (SMI) to get vaccinated as soon as possible. They reiterated that the vaccine is safe.
The timing of the blog comes weeks after group six was first called for vaccination. When HuffPost UK asked whether the post was shared because there was poor uptake among people with severe mental illnesses specifically, NHS England said it was making “good progress” in vaccinating people in this group.
Historically, those with severe mental illnesses have a low uptake of other preventative healthcare programmes, like the flu jab. In the US, for example, influenza vaccination rates among people with severe mental illnesses are as low as 25% and they are less likely to receive preventive or guideline-appropriate health care for concerns such as heart disease and cancer.
An NHS spokesperson tells HuffPost UK: “As the vaccine programme progresses at pace it is essential that no one is left behind and this piece was written to help [make sure] people with SMI – as well as their families, friends, clinicians and where relevant their carers – are aware of the vaccination programme, the helpful resources available to them and the reasonable adjustments they can request to encourage them to get vaccinated.
“We are already making good progress in vaccinating people in this group, as part of the more than 24 million people already jabbed.”
NHS England’s national medical director Professor Stephen Powis has called on anyone who qualifies for a jab, but has not yet received one, to book an appointment soon before slots “dry up” ahead of the vaccine slowdown in April.
Due to delays in shipping and the need for vaccine batches to be retested, far fewer appointments will be available for first doses from next week, as the bulk of available supplies will be used to fully vaccinate people with a second dose.
What is a severe mental illness?
People who live with severe mental illness are those with schizophrenia or bipolar disorder, or any mental illness that causes “severe functional impairment”, according to Public Health England (PHE).
In its guidance, the Welsh government goes one step further and says eligibility stretches to any mental illness that stops a person from being able to take care of themselves. You would be eligible, for example, if you are severely unwell with an eating disorder or you have a diagnosis of personality disorder.
If you aren’t sure whether you have a severe mental illness that falls within the official definition, you should speak to your GP or mental health team who can help advise further. GPs are applying a “flexible approach” to defining what a severe mental illness is, according to the NHS blog.
Why do those with a SMI need to be vaccinated?
If you live with a severe mental illness, you’re at higher risk from severe illness and death from Covid-19, which is why you’re being urged to come forward for the vaccine. People who care for those with a severe mental illness – whether professionally or in an unpaid/family carer role – can also get the jab.
It’s not clear exactly why people with severe mental illness are at increased risk. It’s likely to be down to multiple factors. Andrea Cipriani, psychiatrist and research professor from the Department of Psychiatry at the University of Oxford, wrote in an article for the BMJ that physical risk factors for Covid-19 infection and outcomes are increased in those with severe mental illness, including cardiovascular and respiratory disease, diabetes and obesity.
“Environmental risk factors for Covid‐19 infection, such as socioeconomic deprivation, homelessness, and institutionalisation are also increased [in this group],” he wrote.
A study from the US found people with schizophrenia are almost three times more likely to die from Covid than those without the psychiatric illness.
The higher risk couldn’t be explained by factors that often accompany serious mental health disorders, such as higher rates of heart disease, diabetes and smoking, said researchers at New York University’s (NYU) Grossman School of Medicine. They believe the biology of schizophrenia itself could be making people more vulnerable to the virus. One explanation is an immune system disturbance, possibly tied to the genetics of the disorder, they added.
HuffPost UK has contacted the Joint Committee on Vaccination and Immunisation (JCVI), which informs the groups prioritised for vaccination, for further information on why those with SMI are at increased.
If you have a SMI, you should receive an invitation by letter, text message or phone call inviting you for your vaccine. If you don’t, call your GP or mental health team this week and let them know you want one. Appointments for first doses are still available for the rest of March, but are filling up fast, according to NHS England.
When you book your vaccination, you can let the member of staff know if you need any reasonable adjustments to ensure you can attend your appointment. This could be:
- a longer appointment time or one later in the day;
- somewhere quiet to sit while you wait for your appointment;
- support/ additional reassurance if you are afraid of needles;
- asking if a carer, friend or peer support worker could accompany you to your appointment;
- a home visit if you are housebound and not able to travel to a place that is providing vaccinations;
- a BSL sign-language service.