Prioritizing Care for People with Severe Mental Illness

The COVID-19 pandemic did not create the physical health inequalities encountered by people with severe mental illness (SMI). Long before SARS-CoV-2 emerged, this population faced one of the widest mortality gaps in medicine, losing 10-20 years of life expectancy, largely because of preventable physical illnesses rather than psychiatric disease itself.

The pandemic exposed the persistence of this pre-existing vulnerability and tested whether health systems could respond differently when individuals at highest risk were explicitly prioritised. Studies have shown that people with SMI are at a higher risk of mortality from COVID-19, with some research suggesting that they may lose up to 10-20 years of life expectancy.

## Prioritising Care for People with SMI

The COVID-19 pandemic has highlighted the need to prioritise care for people with severe mental illness. This population faces significant physical health inequalities, including a higher risk of mortality from COVID-19. Studies have shown that people with SMI are at a higher risk of mortality from COVID-19, with some research suggesting that they may lose up to 10-20 years of life expectancy.

## Lessons from COVID-19

The pandemic has tested whether health systems can respond differently when individuals at highest risk are explicitly prioritised. The answer is yes, but only if health systems are willing to adapt and change. This requires a fundamental shift in how we approach healthcare, prioritising the needs of those who are most vulnerable.

| Study | Mortality Gap | Life Expectancy | | --- | --- | --- | | Walker et al. (2015) | 10-20 years | | | Chilman et al. (2026) | | 10-20 years | | Fond et al. (2021) | | | | Raffard et al. (2022) | | | | Mazereel et al. (2021) | | | | Raffard et al. (2023) | | |

The pandemic has also highlighted the need for better communication and collaboration between healthcare providers and people with SMI. This requires a more person-centred approach to care, one that prioritises the needs and preferences of individuals.

In conclusion, the COVID-19 pandemic has highlighted the need to prioritise care for people with severe mental illness. This population faces significant physical health inequalities, including a higher risk of mortality from COVID-19. By prioritising the needs of those who are most vulnerable, we can reduce health inequalities and improve outcomes for people with SMI.