We need a national vaccination strategy for people with severe mental illness

COVID-19 and our nation’s response to it magnifies a sad truth: We have ignored our fellow citizens with severe mental illness.

When we ignore those citizens, we’re leaving behind people with many more barriers to vaccination than the average person. Studies show those living with serious mental illness experience a lack of knowledge and awareness about immunization, a lack of accessibility, a cost barrier, fears about immunization and often no recommendation to receive an immunization from a primary care provider.

Only 25 percent of adults with severe mental illness receive the annual flu vaccine, compared to almost 50 percent of adults in the general population. Without a strategically designed vaccination program able to bring the vaccine to people with serious mental illness, potentially preventable deaths will occur from COVID-19.

According to a bombshell report published in JAMA Psychiatry this January, a schizophrenia diagnosis is the second largest predictor of mortality from COVID-19, after age. Based on this alarming finding, leading scientific experts agree we must minimize the barriers to vaccination and maximize access to vaccines for people with severe mental illness.

As everyone becomes eligible to receive a vaccine, we must develop strategies that go beyond eligibility alone. We created a national strategy to bring the vaccine directly to senior citizens in acknowledgment of the challenges they faced and we must do the same for individuals with severe mental illnesses. We cannot sacrifice individuals with severe mental illness to this pandemic or accept their higher mortality rate as inevitable. People with schizophrenia and bipolar disorder deserve better. 

As leaders of mental health organizations who have seen the devastating effects of COVID-19 on people with severe mental illness, we’re calling on our state and national leaders to provide guidance and funding to state and local health departments to establish COVID-19 vaccination programs specifically designed to increase vaccination rates for people with mental illness. These must include mobile vaccine clinics for aggregate housing facilities, robust outreach to at-risk populations at homeless shelters and encampments, engagement by peer support specialists, training of community health workers, nurses and other public health workers and efforts to address sources of vaccine hesitancy in this population.

Here’s how to put this strategy into action:

First, we must allocate vaccines to inpatient psychiatric hospitals, community mental health centers, community behavioral health organizations and other mental health and substance use service providers who are best positioned to reach those with serious mental illness.

Second, we must create multimedia materials for states and local communities to provide education about the importance of vaccination and dispelling myths about vaccine safety tailored to those with serious mental illness.

Third, we must include peer support specialists in the process — they can connect with those with serious mental illness on a personal level. These peer support specialists should be deployed to community health centers and public health agencies to address emotional or mental health stressors related to vaccination for individuals with severe mental illness.

Fourth, we must gather and publish data on the vaccination rates of people with severe mental illness and determine whether subgroups of people who experience multiple disparities are getting access to vaccines.

As President Biden said in his address to the nation on March 11, the one-year anniversary of the national shutdown due to COVID-19, the most important function of the government is to protect the American people. We must start with those most in need of government action and protection from this deadly virus.

Lisa Dailey is the acting executive director of the Treatment Advocacy Center. Paul Gionfriddo is the president and CEO of Mental Health America.