Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Gen Hosp Psychiatry. 2020 Sep-Oct;66:30-33. doi: 10.1016/j.genhosppsych.2020.06.013. Epub 2020 Jun 30.
COVID-19 can worsen the physical health of individuals with serious mental illness, a vulnerable group already facing physical health disparities. COVID-19 is further reducing access to physical health care due to shutdown of services deemed "non-urgent" and overcrowding of emergency services. Management of chronic diseases, highly prevalent in this group, is undermined due to exacerbation of psychiatric disorders, reduction in availability of social support, and worsening of negative social determinants of health. In this commentary, we discuss the challenges experienced by this group and offer mitigation strategies to reduce: (1) inequalities in access to physical health care; and (2) disruptions to the management of chronic physical conditions in the face of COVID-19. Recommendations include coordinated efforts by health authorities, primary and mental health care organizations, researchers, policymakers, and other stakeholders. These efforts should ensure equitable access to physical health care and implementation of innovative programs to protect the physical health of people with serious mental illness during and following the pandemic.
COVID-19 可能会使患有严重精神疾病的个体的身体健康状况恶化，而这些人属于已经面临健康不平等的弱势群体。由于被认为是“非紧急”的服务关闭以及紧急服务的过度拥挤，COVID-19 进一步减少了他们获得身体健康护理的机会。由于精神障碍恶化、社会支持减少以及健康的负面社会决定因素恶化，这群人中高发的慢性病管理受到了影响。在这篇评论中，我们讨论了这群人所面临的挑战，并提出了减轻以下两个方面的策略：（1）获得身体健康护理的不平等；（2）在 COVID-19 面前，慢性病管理的中断。建议包括卫生当局、初级和精神卫生保健组织、研究人员、政策制定者和其他利益相关者的协调努力。这些努力应确保公平获得身体健康护理，并实施创新计划，以保护严重精神疾病患者在大流行期间和之后的身体健康。
