Severe mental illness (SMI), which includes schizophrenia, bipolar disorder and major depression, affects about one in ten people. People with SMI die 10-20 years sooner than the general population, largely due to poorer physical health, in particular conditions that affect the heart or blood vessels, such as heart attack. Compared to people without a SMI, those with a SMI are more likely to develop these conditions and less likely to survive such events. The reasons are poorly understood, but differences in care may contribute. The COVID-19 pandemic may have worsened these differences in disease occurrence, survival and/or receipt of care.
Using health data from England, we will:
- Investigate whether the COVID-19 pandemic worsened the links between SMI and occurrence of heart attack and other diseases of the heart or blood vessels.
- Examine how the COVID-19 pandemic has affected the links between SMI and receipt of care and death following a heart attack.
Additionally, we will interview patients with SMI who have had a heart attack, as well as healthcare workers involved in delivering care for heart attack, to help us to understand our findings and to provide insight into experiences of the heart attack care pathway in particular, including during the COVID-19 pandemic.
We will establish whether the pandemic and the resulting disruption to health care provision/service disproportionately affected people with a SMI and whether any worsening of differences has persisted. This understanding will inform strategies to address these mental health inequalities and mitigate the impact of future disruptions to health care provision.