Health risk behaviours among people with severe mental ill health during the COVID-19 pandemic: Analysis of linked cohort data
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Abstract
People with severe mental ill health (SMI) experience a mortality gap of 15–20 years. COVID-19 has amplified population health inequalities, and there is concern that people with SMI will be disproportionately affected. Understanding how health risk behaviours have changed during the pandemic is important when developing strategies to mitigate future increases in health inequalities.
Methods
We sampled from an existing cohort of people with SMI. Researchers contacted participants by phone or post to invite them to take part in a survey about how the pandemic had affected them. We asked people about their health risk behaviours and how these had changed during the pandemic. We created an index of changed behaviours, comprising dietary factors, smoking, lack of exercise, and drinking patterns. By creating data linkages, we compared their responses during pandemic restrictions to responses they gave prior to the pandemic.
Outcomes
367 people provided health risk data. The mean age of the participants was 50.5 (range = 20 to 86, SD ± 15.69) with 51.0% male and 77.4% white British. 47.5% of participants reported taking less physical activity during the pandemic and of those who smoke 54.5% reported smoking more heavily. Self-reported deterioration in physical health was significantly associated with an increase in health risk behaviours (adjusted OR for physical health 1.59, 95%CI 1.22–2.07; adjusted OR for Age 0.99, 95%CI 0.98–1.00).
Interpretation
COVID-19 is likely to amplify health inequalities for people with SMI. Health services should target health risk behaviours for people with SMI to mitigate the immediate and long lasting impacts of the COVID-19 pandemic.
Article activity feed
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SciScore for 10.1101/2021.03.29.21254527: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The problem of potentially unrepresentative self-selected samples in COVID-19 studies has been shown to be a particular limitation in mental health research (24). Second, the OWLS COVID-19 study participants had previously been recruited to a large transdiagnostic study of people with SMI, and had consented to be contacted about …
SciScore for 10.1101/2021.03.29.21254527: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The problem of potentially unrepresentative self-selected samples in COVID-19 studies has been shown to be a particular limitation in mental health research (24). Second, the OWLS COVID-19 study participants had previously been recruited to a large transdiagnostic study of people with SMI, and had consented to be contacted about future research. This allowed us to recruit to the OWLS COVID -19 study rapidly in response the COVID-19 pandemic, whilst still using a sampling strategy. This study does however have some weaknesses. First, whilst every effort was made to include the most vulnerable people from what is a vulnerable group we were rarely able to recruit from inpatient settings or people under the care of assertive outreach teams. When potential participants were on an inpatient ward we asked their care team if they could support the person to take part where it was appropriate to do so. Unfortunately there were very few cases where this was possible. We also attempted to include people in community supported living facilities and asked their care team to support them to take part, in some cases this was possible but in others it proved more difficult.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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