Mortality in patients with mental health conditions increased during COVID-19 pandemic

The number of deaths amongst those with mental health conditions and intellectual disabilities was amplified during the novel coronavirus (COVID-19) pandemic, according to a new study based on more than 160,000 patients published in the journal The Lancet Regional Health – Europe.

Before the pandemic, the rates of mortality in those with severe mental health conditions were already higher than the general population. Researchers found that between March and June 2020, during the first wave of COVID-19, mortality further increased in people with mental health conditions and intellectual disabilities compared with the general population. 

Deaths from COVID-19 among those with learning disabilities were nine times higher than the general population during the first lockdown period, according to the study, and for those with eating disorders almost five times higher. For those with personality disorders and those with dementia, deaths from COVID-19 were about four times higher than the general population and more than three times higher in people with schizophrenia.

For the study, researchers analyzed anonymized 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 standardized 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 standardized against population data from London, to assess whether estimates were accounted for by local area-level effects.

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, according to the study.  

The research was part-funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC) and used the Clinical Record Interactive Search (CRIS) system to analyze anonymized data from clinical e-records of patients from South London.

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