COVID-19 pandemic mitigation for the high-risk patients served by the community mental health system

Abstract

Multiple chronic medical conditions are common to patients served by the community mental health (CMH) system. Medical diseases are present in at least 50% of all patients with psychiatric conditions, and severe mental disorders are associated with significant physical comorbidity and mortality. Early data show that individuals with preexisting multiple chronic conditions have a higher mortality risk when they are symptomatic with COVID-19. Although mitigation guidelines and recommendations are constantly being reviewed and updated, we found no specific recommendations targeting the vulnerable population who use CMH systems or the publicly funded and managed behavioral health entities which serve them. We reviewed the Centers for Disease Control and Prevention guidelines regarding infection control in health care facilities that provide ambulatory care, including behavioral health clinics, as well as reviewed recent population outcomes data. We posit that the population served by the CMH systems is a higher-risk cohort than the general population and offer recommendations for effective infection prevention strategies specific to this population.