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2.
Pilot Feasibility Stud ; 7(1): 116, 2021 May 31.
Article in English | MEDLINE | ID: covidwho-1280599

ABSTRACT

BACKGROUND: People with serious mental illnesses (SMI) such as schizophrenia often also have physical health illnesses and interventions are needed to address the resultant multimorbidity and reduced life expectancy. Research has shown that volunteers can support people with SMI. This protocol describes a feasibility randomised controlled trial (RCT) of a novel intervention involving volunteer 'Health Champions' supporting people with SMI to manage and improve their physical health. METHODS: This is a feasibility hybrid II randomised effectiveness-implementation controlled trial. The intervention involves training volunteers to be 'Health Champions' to support individual people with SMI using mental health services. This face-to-face or remote support will take place weekly and last for up to 9 months following initial introduction. This study will recruit 120 participants to compare Health Champions to treatment as usual for people with SMI using secondary community mental health services in South London, UK. We will measure the clinical and cost effectiveness including quality of life. We will measure the implementation outcomes of acceptability, feasibility, appropriateness, fidelity, barriers and enablers, unintended consequences, adoption and sustainability. DISCUSSION: There is a need for interventions to support people with SMI with their physical health. If this feasibility trial is successful, a definitive trial will follow to fully evaluate the clinical, cost and implementation effectiveness of Health Champions supporting people with SMI. TRIAL REGISTRATION: ClinicalTrials.gov, registration no: NCT04124744 .

3.
Front Psychol ; 12: 647606, 2021.
Article in English | MEDLINE | ID: covidwho-1247908

ABSTRACT

Serious mental health disorders are increasing among college students and university counseling services are often overburdened. Mobile applications for mental health have been growing exponentially in the last decade and they are emerging in university settings as a promising tool to promote and intervene in college students' mental health. Additionally, considering the recent covid-19 pandemic, mHealth interventions, due to its nature and possibilities, may play an important role in these institutions. Our main objectives are to explore mhealth interventions in universities, regarding its conceptual framework, acceptability and efficacy outcomes and understand its impact and contributions to address treatment delivery and psychological difficulties resulting from covid-19 pandemic. The literature search was conducted in scientific databases, namely, Web of Science, Pubmed, and Scopus. A search in app stores was not conducted, thus regarding commercially available apps, only those found in our database search were included in our review. We selected studies with mobile applications addressing psychological interventions for college students. A total of 2,158 participants were included in the 8 selected studies and most interventions were delivered through mobile apps only and based in cognitive behavioral therapy. Results suggested that college students accept and adhere to these interventions and preliminary evidence of efficacy was demonstrated in different disorders, such as stress, anxiety, depression and risky behaviors such as alcohol and tobacco abuse and sexual knowledge. We conclude that universities, particularly college counseling services, may benefit from mhealth interventions, not only to address college students' mental health but to decrease some of its difficulties related to lack of human resources. Specifically in covid-19 pandemic context, these interventions may contribute significantly by promoting and delivering psychological interventions at a safe distance.

4.
Psychiatr Serv ; 72(11): 1324-1327, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1242223

ABSTRACT

OBJECTIVE: The authors examined access to care among persons with serious mental illness during the pandemic and disparities in use of virtual care among this population versus among individuals with other psychiatric diagnoses. METHODS: Data from the Veterans Health Administration were used to examine whether the number of visits for serious mental illness differed for January-September 2019 versus the same period in 2020. Mixed-effects regression analyses tested whether the post-COVID-19 rate of growth in virtual care differed for people with serious mental illnesses versus those with other diagnoses. RESULTS: Fewer visits for serious mental illnesses occurred during the initial weeks of the pandemic but not subsequently. The rate of growth in video visits during 2020 was slower for serious mental illnesses than for other psychiatric diagnoses. CONCLUSIONS: Several months after the pandemic's start, the total number of visits for serious mental illnesses was similar to 2019; however, adoption of video care was slower than for other psychiatric diagnoses.


Subject(s)
COVID-19 , Mental Disorders , Veterans , Health Services Accessibility , Humans , Mental Disorders/epidemiology , Pandemics , SARS-CoV-2
5.
Telemed J E Health ; 27(8): 947-954, 2021 08.
Article in English | MEDLINE | ID: covidwho-1240875

ABSTRACT

Introduction: Due to the COVID-19 pandemic and prompted by recent federal and state policy shifts impacting behavioral health care delivery, the use of telebehavioral health has rapidly increased. This qualitative study describes behavioral health provider perspectives on the use of telebehavioral health before and during the pandemic and how policy changes impacted access to and utilization of behavioral health services in Michigan. Materials and Methods: A convenience sample of 31 licensed and nonlicensed behavioral health providers operating in Michigan participated in semi-structured interviews between July and August 2020. Interviews were audio-recorded, transcribed, and analyzed by using inductive methods. Results: The thematic analysis resulted in four overarching themes: (1) increased access to care; (2) maintenance of quality of care; (3) minimal privacy concerns; and (4) client and provider satisfaction. Discussion: During and post-pandemic, providers need flexibility to determine whether in-person or telebehavioral health services, including audio-only, best meet client needs. Providers identified several populations for which telebehavioral health was less accessible: clients with serious mental illness and substance use disorder, those with no broadband Internet access, children, and older adults. Additional training in telebehavioral health service provision can positively impact quality of care. Conclusion: Policies that support reimbursement parity and expand provider use of telebehavioral health services should be maintained after the COVID-19 pandemic ends to avoid imposing barriers to accessing behavioral health care barriers post-pandemic.


Subject(s)
COVID-19 , Telemedicine , Aged , Child , Female , Humans , Pandemics , Qualitative Research , SARS-CoV-2
6.
Psychiatr Serv ; 72(10): 1209-1212, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1238633

ABSTRACT

OBJECTIVE: This study sought to characterize the incidence of COVID-19 illness, hospitalization, and death among congregate and noncongregate cohorts served by a New York City behavioral health agency. METHODS: From March 9 to May 3, 2020, data were collected on COVID-19 symptoms, testing, hospitalization, and mortality for 8,256 individuals living in 29 congregate programs (residences and homeless shelters) or served by 41 noncongregate programs (scattered-site housing or outpatient treatment programs). RESULTS: Of the 218 (2.6%) individuals who developed COVID-19-like illness, 84 (39%) were able to obtain testing. Of the 77 individuals who tested positive, 49 (64%) were hospitalized and 19 (25%) died. Congregate housing, age over 45, and intellectual/developmental disabilities were significantly associated with hospitalization and death. CONCLUSIONS: Further research on risk and preventive factors is needed to address the high risk for people with serious mental illnesses and intellectual/developmental disabilities during a pandemic, particularly for those living in congregate housing.


Subject(s)
COVID-19 , Homeless Persons , Housing , Humans , New York City/epidemiology , SARS-CoV-2
7.
J Nerv Ment Dis ; 209(8): 543-546, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1234178

ABSTRACT

ABSTRACT: Social distancing due to COVID-19 may adversely impact treatment of adults with serious mental illness, especially those receiving intensive forms of community-based care, in part through weakening of the therapeutic alliance. Veterans and staff at a Veterans Affair (VA) medical center were surveyed 3 months after social distancing disrupted usual service delivery in intensive community-based treatment programs. Veterans (n = 105) and staff (n = 112) gave similar multi-item ratings of service delivery after social distancing, which involved far less face-to-face contact and more telephone contact than usual and rated their therapeutic alliances and clinical status similarly as "not as good" on average than before social distancing. Self-reported decline in therapeutic alliance was associated with parallel decline in clinical status indicators. Both veterans and staff indicated clear preference for return to face-to-face service delivery after the pandemic with some telehealth included.


Subject(s)
Attitude of Health Personnel , COVID-19 , Case Management/standards , Community Mental Health Services/standards , Delivery of Health Care/standards , Patient Preference , Physical Distancing , Telemedicine/standards , Therapeutic Alliance , Adult , COVID-19/prevention & control , Female , Humans , Male , Middle Aged , United States , United States Department of Veterans Affairs , Veterans
8.
J Behav Health Serv Res ; 48(4): 610-616, 2021 10.
Article in English | MEDLINE | ID: covidwho-1227895

ABSTRACT

Individuals recently released from jail or prison with serious mental illnesses may be vulnerable to the coronavirus pandemic. This study aims to understand how they experienced the pandemic during initial stay-at-home orders in New York City. Structured surveys and in-depth semi-structured interviews examined the impact of the pandemic on participants. Survey responses are presented as percentages. Thematic analysis was used to code and analyze in-depth interviews. All participants (N = 5) knew about the coronavirus pandemic, and most took steps to minimize risk. Participants experienced changes to their services, including suspensions of some supportive services. They also reported an increase in psychiatric symptoms but utilized a variety of coping mechanisms in response. Community reintegration was essentially on hold as supportive services were suspended. Comprehensive reentry services may need to be adapted during the pandemic to address the multiple needs of individuals and to facilitate community reintegration.


Subject(s)
COVID-19 , Mental Disorders , Humans , Jails , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health , Prisons , SARS-CoV-2
9.
JMIR Ment Health ; 8(3): e25542, 2021 Mar 11.
Article in English | MEDLINE | ID: covidwho-1133828

ABSTRACT

BACKGROUND: In the context of the COVID-19 pandemic, many behavioral health services have transitioned to teletherapy to continue delivering care for patients with mental illness. Studies that evaluate the outcome of this rapid teletherapy adoption and implementation are pertinent. OBJECTIVE: This single-arm, nonrandomized pilot study aimed to assess the feasibility and initial patient-level outcomes of a psychiatric transitional day program that switched from an in-person group to a video teletherapy group during the COVID-19 pandemic. METHODS: Patients with transdiagnostic conditions who were at risk of psychiatric hospitalization were referred to the Adult Transitions Program (ATP) at a large academic medical center in the United States. ATP was a 3-week intensive outpatient program that implemented group teletherapy guided by cognitive and behavioral principles delivered daily for 3 hours per day. Feasibility was assessed via retention, attendance rate, and rate of securing aftercare appointments prior to ATP discharge. Patients completed standardized patient-reported outcome measures at admission and discharge to assess the effectiveness of the program for improving quality of mental health, depression, anxiety, and suicide risk. RESULTS: Patients (N=76) started the program between March and August of 2020. Feasibility was established, with 70 of the 76 patients (92%) completing the program and a mean attendance of 14.43 days (SD 1.22); also, 71 patients (95%) scheduled at least one behavioral health aftercare service prior to ATP discharge. All patient-level reported outcomes demonstrated significant improvements in depression (95% CI -3.6 to -6.2; Cohen d=0.77; P<.001), anxiety (95% CI -3.0 to -4.9; Cohen d=0.74; P<.001), overall suicide risk (95% CI -0.5 to -0.1; Cohen d=0.41; P=.02), wish to live (95% CI 0.3 to 1.0; Cohen d=0.39; P<.001), wish to die (95% CI -0.2 to -1.4; Cohen d=0.52; P=.01), and overall mental health (95% CI 1.5 to 4.5; Cohen d=0.39; P<.001) from admission to discharge. CONCLUSIONS: Rapid adoption and implementation of a group-based teletherapy day program for adults at risk of psychiatric hospitalization appeared to be feasible and effective. Patients demonstrated high completion and attendance rates and reported significant improvements in psychosocial outcomes. Larger trials should be conducted to further evaluate the efficacy and effectiveness of the program through randomized controlled trials.

10.
Drug Saf ; 43(12): 1315-1322, 2020 12.
Article in English | MEDLINE | ID: covidwho-1092872

ABSTRACT

INTRODUCTION: In the stressful context of the coronavirus disease 2019 (COVID-19) pandemic, some reports have raised concerns regarding psychiatric disorders with the use of hydroxychloroquine. In this study, we reviewed all psychiatric adverse effects with hydroxychloroquine in COVID-19 patients, as well as in other indications, reported in VigiBase, the World Health Organization's (WHO) global database of individual case safety reports. METHODS: First, we analyzed all psychiatric adverse effects, including suicide, of hydroxychloroquine in COVID-19 patients reported to 16 June 2020. We also performed disproportionality analysis to investigate the risk of reporting psychiatric disorders with hydroxychloroquine compared with remdesivir, tocilizumab, or lopinavir/ritonavir prescribed in COVID-19 patients. We used reporting odds ratios (RORs) and their 95% confidence intervals (CIs) to calculate disproportionality. Second, we sought to examine the psychiatric safety profile of hydroxychloroquine in other indications (before 2020). RESULTS: Among the 1754 reports with hydroxychloroquine in COVID-19 patients, we found 56 psychiatric adverse effects. Half of these adverse effects were serious, including four completed suicides, three cases of intentional self-injury, and 12 cases of psychotic disorders with hallucinations. Compared with remdesivir, tocilizumab, or lopinavir/ritonavir, the use of hydroxychloroquine was associated with an increased risk of reporting psychiatric disorders (ROR 6.27, 95% CI 2.74-14.35). Before 2020, suicide was the main cause of death among all adverse drug reactions reported with hydroxychloroquine, followed by cardiac adverse effects (cardiomyopathy) and respiratory failure. CONCLUSIONS: This pharmacovigilance analysis suggests that COVID-19 patients exposed to hydroxychloroquine experienced serious psychiatric disorders, and, among these patients, some committed suicide. Further real-world studies are needed to quantify the psychiatric risk associated with hydroxychloroquine during the COVID-19 pandemic.


Subject(s)
Antiviral Agents/adverse effects , COVID-19/drug therapy , Hallucinations/chemically induced , Hydroxychloroquine/adverse effects , Psychoses, Substance-Induced/etiology , Self-Injurious Behavior/chemically induced , Suicide/statistics & numerical data , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/analogs & derivatives , Adult , Aged , Aged, 80 and over , Alanine/adverse effects , Alanine/analogs & derivatives , Antibodies, Monoclonal, Humanized/adverse effects , Databases, Pharmaceutical , Drug Combinations , Female , Hallucinations/epidemiology , Humans , Lopinavir/adverse effects , Male , Mental Disorders/chemically induced , Mental Disorders/epidemiology , Middle Aged , Psychoses, Substance-Induced/epidemiology , Ritonavir/adverse effects , Self-Injurious Behavior/epidemiology , Suicide, Attempted/statistics & numerical data , Young Adult
11.
Health Aff (Millwood) ; 40(1): 170-173, 2021 01.
Article in English | MEDLINE | ID: covidwho-1094072

ABSTRACT

A woman with serious mental illness cycles between a state hospital, shelters, nursing homes, and psychiatric units, with no permanent place to land.


Subject(s)
Mental Disorders , Female , Humans , Mental Disorders/therapy , Nursing Homes
12.
J Nerv Ment Dis ; 209(1): 49-53, 2021 01.
Article in English | MEDLINE | ID: covidwho-1066475

ABSTRACT

The novel coronavirus pandemic and the resulting expanded use of telemedicine have temporarily transformed community-based care for individuals with serious mental illness (SMI), challenging traditional treatment paradigms. We review the rapid regulatory and practice shifts that facilitated broad use of telemedicine, the literature on the use of telehealth and telemedicine for individuals with SMI supporting the feasibility/acceptability of mobile interventions, and the more limited evidence-based telemedicine practices for this population. We provide anecdotal reflections on the opportunities and challenges for telemedicine drawn from our daily experiences providing services and overseeing systems for this population during the pandemic. We conclude by proposing that a continued, more prominent role for telemedicine in the care of individuals with SMI be sustained in the post-coronavirus landscape, offering future directions for policy, technical assistance, training, and research to bring about this change.


Subject(s)
Attitude of Health Personnel , COVID-19 , Community Health Services , Health Services Accessibility , Mental Disorders/therapy , Mental Health Services , Patient Acceptance of Health Care , Telemedicine , Community Health Services/economics , Community Health Services/organization & administration , Community Health Services/standards , Health Services Accessibility/economics , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Humans , Mental Health Services/economics , Mental Health Services/organization & administration , Mental Health Services/standards , Telemedicine/economics , Telemedicine/organization & administration , Telemedicine/standards
13.
Community Ment Health J ; 57(1): 10-17, 2021 01.
Article in English | MEDLINE | ID: covidwho-1064541

ABSTRACT

Changes to community psychiatry during COVID-19 are unprecedented and without clear guidelines. Minimizing disruption, ensuring quality care to the already vulnerable people with serious mental illness is crucial. We describe and reflect our adaptations and innovations at one community psychiatry program, based on three key principles. In (i) Defining and maintaining essential services while limiting risk of contagion, we discuss such strategies and ways to assess risks, implement infection control, and other creative solutions. In (ii) Promoting health and mitigating physical and mental health impacts, we reflect on prioritizing vulnerable patients, dealing with loss of community resources, adapting group programs, and providing psychoeducation, among others. In (iii) Promoting staff resilience and wellness, we describe building on strength of the staff early, addressing staff morale and avoiding moral injury, and valuing responsive leadership. We also identify limitations and potential further improvements, mindful that COVID-19 and similar crises are likely recurring realities.


Subject(s)
COVID-19 , Community Mental Health Centers/organization & administration , Community Mental Health Services/organization & administration , Continuity of Patient Care/organization & administration , Mental Disorders/psychology , Mental Disorders/therapy , Disaster Planning , Humans , Mental Health , Pandemics , SARS-CoV-2
14.
Implement Sci Commun ; 2(1): 12, 2021 Feb 03.
Article in English | MEDLINE | ID: covidwho-1063205

ABSTRACT

BACKGROUND: People diagnosed with a serious mental illness have worse physical health and lower life expectancy than the general population. Integration of mental and physical health services is seen as one service development that could better support this. This protocol describes the evaluation of the provision of a Virtual Physical Health Clinic (VPHC) and Consultant Connect (CC) services to one UK-based mental health Trust. METHODS: Prospective, formative, pragmatic evaluation using both quantitative and qualitative techniques and driven by implementation science theoretical frameworks. The VPHC and CC are described along with the methodology being used to rapidly evaluate their implementation, effectiveness and potential economic impact in order to inform future roll out. We will assess the implementation process through quantitative data on uptake and reach and through self-reported data to be collected from interviews and the use of validated implementation outcome assessment measures. We will assess implementation strategies using the Expert Recommendations for Implementing Change (ERIC) strategies as a framework. We will assess the health economic impact of both services using established health economic methods including cost comparison scenarios and health service utilisation analyses. DISCUSSION: Supporting the physical health management of people in psychiatric inpatient units is important in improving the physical health of this population. Integration of mental and physical health can help this to happen effectively. This initiative provides one of the first service evaluation protocols of its kind to be reported in the UK at the time of the COVID-19 pandemic.

15.
Int J Psychiatry Med ; 56(4): 255-265, 2021 07.
Article in English | MEDLINE | ID: covidwho-1058157

ABSTRACT

BACKGROUND: There is still a lot unknown about the novel Coronavirus Disease 19 (COVID-19) and its effects in humans. This pandemic has posed several challenging clinical situations to healthcare providers. OBJECTIVE: We hope to highlight the distinctive challenges that COVID-19 presents in patients with serious mental illness and what steps primary medical teams can take to co-manage these patients with the psychiatry consultants. METHODS: We present a retrospective chart review of four patients who were on psychotropic polypharmacy and admitted to our hospital from the same long-term psychiatric facility with COVID-19 delirium and other associated medical complications. RESULTS: We illustrate how the primary medical teams and psychiatrists collaborated in clinical diagnosis, treatment, and management. CONCLUSIONS: Patients with serious mental illness and COVID-19 infection require active collaboration between primary medical teams and psychiatrists for diagnostic clarification, reduction of psychotropic polypharmacy to avoid adverse effects and drug-drug interactions, prevention of psychiatric decompensation, and active management of agitation while balancing staff and patient safety concerns.


Subject(s)
Bipolar Disorder/complications , COVID-19/complications , COVID-19/psychology , Delirium/complications , Psychotic Disorders/complications , Schizophrenia/complications , Bipolar Disorder/drug therapy , COVID-19/drug therapy , Delirium/drug therapy , Drug Interactions , Female , Humans , Male , Middle Aged , Pandemics , Polypharmacy , Psychotic Disorders/drug therapy , Psychotropic Drugs/therapeutic use , Retrospective Studies , SARS-CoV-2 , Schizophrenia/drug therapy
16.
Am Psychol ; 75(9): 1343-1345, 2020 12.
Article in English | MEDLINE | ID: covidwho-1003294

ABSTRACT

This award is intended to recognize outstanding independent practitioners in psychology. Nominations are considered for psychologists working in any area of clinical specialization, health services provision, or consulting, and services provided to any patient population or professional clientele in an independent setting. Services provided to diverse client groups or patient populations, including but not limited to children/adolescents/ adults/older adults, urban/rural/frontier populations, minority populations, and persons with serious mental illness are considered. Contributions are judged distinguished by virtue of peer recognition, advancement of the public's recognition of psychology as a profession, relevant professional association honors, or other meritorious accomplishments denoting excellence as a practitioner, including advancement of the profession. The 2020 recipient of the APA Professional Contributions Awards were selected by the 2019 Board of Professional Affairs (BPA). Adam S. Weissman is a health care innovator, leader, and visionary, with a mission to revolutionize the mental and behavioral health field by increasing access to, disseminating, and implementing best practices and evidencebased treatments for underserved communities. Adam S. Weissman has passionately pursued his quest, achieving unparalleled success in developing a 15-site, multistate, mission-based behavioral health care organization, The Child & Family Institute, and the nonprofit Weissman Children's Foundation, currently providing large-scale pro bono COVID-19 relief nationally. Adam S. Weissman is president of numerous psychological and mental health associations, a prolific writer and researcher, and a recipient of many service and academic awards. Undoubtedly, he will continue to transform lives and revolutionize the field. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

17.
Mil Med ; 186(9-10): e956-e961, 2021 08 28.
Article in English | MEDLINE | ID: covidwho-998429

ABSTRACT

INTRODUCTION: There is emerging evidence to support that the COVID-19 pandemic and related public health measures may be associated with negative mental health sequelae. Rural populations in particular may fair worse because they share many unique characteristics that may put them at higher risk for adverse outcomes with the pandemic. Yet, rural populations may also be more resilient due to increased sense of community. Little is known about the impact of the pandemic on the mental health and well-being of a rural population pre- and post-pandemic, especially those with serious mental illness. MATERIAL AND METHODS: We conducted a longitudinal, mixed-methods study with assessments preceding the pandemic (between October 2019 and March 2020) and during the stay-at-home orders (between April 23, 2020, and May 4, 2020). Changes in hopelessness, suicidal ideation, connectedness, and treatment engagement were assessed using a repeated-measures ANOVA or Friedman test. RESULTS: Among 17 eligible participants, 11 people were interviewed. Overall, there were no notable changes in any symptom scale in the first 3-5 months before the pandemic or during the stay-at-home orders. The few patients who reported worse symptoms were significantly older (mean age: 71.7 years, SD: 4.0). Most patients denied disruptions to treatment, and some perceived telepsychiatry as beneficial. CONCLUSIONS: Rural patients with serious mental illness may be fairly resilient in the face of the COVID-19 pandemic when they have access to treatment and supports. Longer-term outcomes are needed in rural patients with serious mental illness to better understand the impact of the pandemic on this population.


Subject(s)
COVID-19 , Mental Disorders , Psychiatry , Telemedicine , Aged , Humans , Mental Disorders/epidemiology , Mental Health , Pandemics , Public Health , Rural Population , SARS-CoV-2
19.
Prim Care Companion CNS Disord ; 22(6)2020 Nov 05.
Article in English | MEDLINE | ID: covidwho-916456

ABSTRACT

OBJECTIVE: To report the clinical characteristics and transmission rate of coronavirus disease 2019 (COVID-19) in a community inpatient long-term care psychiatric rehabilitation facility designed for persons with serious mental illness to provide insight into transmission and symptom patterns and emerging testing protocols, as well as medical complications and prognosis. METHODS: This study examined a cohort of 54 residents of a long-term care psychiatric rehabilitation program from March to April 2020. Baseline demographics, clinical diagnoses, and vital signs were examined to look for statistical differences between positive versus negative severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) groups. During the early phase of the pandemic, the facility closely followed the local shelter-in-place order (starting March 19, 2020) and symptom-based testing. RESULTS: Of the residents, the primary psychiatric diagnoses were schizoaffective disorder: 28 (51.9%), schizophrenia: 21 (38.9%), bipolar I disorder: 3 (5.5%), and unspecified psychotic disorder: 2 (3.7%). Forty (74%) of 54 residents tested positive for SARS-COV-2, with a doubling time of 3.9 days. There were no statistical differences between the positive SARS-COV-2 versus negative groups for age or race/ethnicity. Psychiatric and medical conditions were not significantly associated with contracting SARS-COV-2, with the exception of obesity (n = 17 [43%] positive vs n = 12 [86%] negative, P = .01). Medical monitoring of vital signs and symptoms did not lead to earlier detection. All of the residents completely recovered, with the last resident no longer showing any symptoms 24 days from the index case. CONCLUSION: Research is needed to determine optimal strategies for long-term care mental health settings that incorporate frequent testing and personal protective equipment use to prevent rapid transmission of SARS-COV-2.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Psychotic Disorders/rehabilitation , Rehabilitation Centers , Schizophrenia/rehabilitation , Adult , African Americans , Asian Americans , Betacoronavirus , Bipolar Disorder/epidemiology , Bipolar Disorder/rehabilitation , COVID-19 , COVID-19 Testing , California/epidemiology , Clinical Laboratory Techniques , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/transmission , Diabetes Mellitus/epidemiology , Gastroesophageal Reflux/epidemiology , Humans , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Hypothyroidism/epidemiology , Infection Control , Long-Term Care , Mass Screening , Middle Aged , Obesity/epidemiology , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Pneumonia, Viral/transmission , Psychiatric Rehabilitation , Psychotherapy, Group , Psychotic Disorders/epidemiology , Recreation , Rehabilitation, Vocational , SARS-CoV-2 , Schizophrenia/epidemiology , Smoking/epidemiology , Visitors to Patients
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