Psychiatric conditions may increase chances of getting COVID-19
There was a 7% higher risk of developing a breakthrough infection when compared to those without a behavioral health issue.
Photo: LucaLorenzelli/Getty Images
Behavioral health has grabbed a bigger share of the spotlight during the COVID-19 pandemic, in part because the emergence of remote care technologies such as telehealth that have made it easier, and somewhat less stigmatizing, to seek care for mental health.
New research points to another benefit of behavioral telehealth: Certain psychiatric conditions make it more likely that a person could contract breakthrough COVID-19.
This bolsters the case for strengthening behavioral healthcare access, according to findings published in JAMA Network Open. A "breakthrough" infection occurs when someone contracts COVID-19 despite having been vaccinated.
The research looked at electronic health record data from more than a quarter million patients at the San Francisco Veterans Affairs Health Care System, about 51% of whom had received a diagnosis for at least one psychiatric disorder within the last five years.
The disorders ranged from depression, anxiety, adjustment disorder and posttraumatic stress to substance use disorder, bipolar disorder, and various eating disorders.
Of those with at least one diagnosis, about 15% developed a breakthrough COVID-19 infection. That translates to about a 7% higher risk of developing a breakthrough infection when compared to those without a behavioral health issue.
Patients with the highest risk of a breakthrough infection were those 65 or older who also had a substance use disorder. Twenty-four percent of such patients had a breakthrough infection, while 23% with psychotic disorders became infected; 16% of those with bipolar disorder; 15% of those with adjustment disorder; and 12% of those with anxiety.
"Although some of the larger observed effect sizes are compelling at an individual level, even the relatively modest effect sizes may have a large effect at the population level when considering the high prevalence of psychiatric disorders and the global reach and scale of the pandemic," the authors wrote.
More research is needed to understand why such breakthrough infections are more prevalent among behavioral healthcare patients.
WHAT'S THE IMPACT
The need for behavioral health has been one of the biggest drivers of the growth of telehealth, with a 2021 report from health insurer Cigna finding a 27% increase in behavioral health outpatient care compared to pre-pandemic levels.
Another study showed that mental health services accounted for the most common use of telehealth during the early days of the pandemic. In the midst of skyrocketing depression rates, the findings show that more patients used telehealth for behavioral rather than physical conditions.
This shift to telehealth, particularly video, was enabled by time-limited, regulatory changes related to reimbursement, privacy standards for telehealth technology, and licensure. Lessons from utilization during this period can inform policy for the post-COVID-19 era.
THE LARGER TREND
In September, Solera Health CEO Mary Langowski told Healthcare Finance News that the need for mental healthcare services have increased, and that employers need to step up.
"We're seeing a huge demand and a huge need for more behavioral health services and providers," said Langowski. "People are so impacted by this. They're anxious about the isolation, but they're also anxious about what does life look like on the other side as we come back together. And employers are starting to recognize they've got a real role to play and a responsibility in addressing these issues, because if they don't step up, no one else will."
In particular, beneficiaries are looking for ease of access, she said. Even if they have the benefits and coverage available to them, many are unable to find providers. Digital applications are helping to address these issues somewhat, but patients need to engage with the system when they need it, and in a more convenient fashion, said Langowski.
Robert Cohen, former president of Appriss Health, told HIMSS TV last year that behavioral healthcare still needs to overcome the stigma, and more needs to be done to improve access.
"We've all heard the narrative that there's not enough treatment, and it's really hard to find treatment," said Cohen. "But there is enough treatment, and there are other challenges and other reasons people aren't getting the care that they need."
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
