People with severe MH conditions to be prioritised for vaccine

[Orangeblossom77777]

Just thought would share in case anyone interested.

www.rethink.org/advice-and-information/covid-19-support/covid-19-vaccine-and-people-living-with-severe-mental-illness/

No. That’s not what is happening and not what your link says
Your link says
So, if you live with severe mental illness the JCVI say you should be offered a vaccine once one has been offered to people who are

residents in a care home for older adults,
frontline health, social care and care home workers,
65 and over, and
clinically extremely vulnerable.

Yes, after the CEV there is another group of people with underlying conditions. See

www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-2-december-2020/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-2-december-2020

It is referred to under that category.

Underlying health conditions
There is good evidence that certain underlying health conditions increase the risk of morbidity and mortality from COVID-19. When compared to persons without underlying health conditions, the absolute increased risk in those with underlying health conditions is considered generally to be lower than the increased risk in persons over the age of 65 years (with the exception of the clinically extremely vulnerable).

The committee’s advice is to offer vaccination to those aged 65 years and over followed by those in clinical risk groups aged 16 years and over.

The risk groups identified by the committee are set out below:

chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and severe asthma
chronic heart disease (and vascular disease)
chronic kidney disease
chronic liver disease
chronic neurological disease including epilepsy
Down’s syndrome
severe and profound learning disability
diabetes
solid organ, bone marrow and stem cell transplant recipients
people with specific cancers
immunosuppression due to disease or treatment
asplenia and splenic dysfunction
morbid obesity
severe mental illness
Individuals within these risk groups who are clinically extremely vulnerable are discussed separately (see above)

Makes a lot of sense. People with server mental health issues are likely to have poor physical health and to be in contact with healthcare professionals and maybe other patients. Imagine if covid spread through an inpatient mental health facility. It won’t be good and as a general rule of thumb it’s not good for people with server mental health issues to be isolated from others.

Health outcomes amongst people with SMI are appalling, they are also much more likely to be living with undiagnosed or poorly managed physical health conditions and may be reliant on care from other people.

It may also be about the meds, some have metabolic issues as well- linked to e.g. diabetes which could be a link. There is some more stuff here..

www.cebm.net/covid-19/severe-mental-illness-and-risks-from-covid-19/

Wonder how they will categorise it. Will it be people on certain meds perhaps.

It’s well documented people with SMI have decreased life expectancy and when they do report physical health issues it’s minimised due to diagnostic overshadowing

You’ve now expanded upon your original link . So those SMI clients potentially fall into the extremely vulnerable clients

Wonder how they will categorise it. Will it be people on certain meds perhaps clozapine is an obvious start point and it’s already monitored by nurses in clinics

Many have poor physical health

medication can impact the immune system that makes them at a higher risk should the contract Covid

How would consent work for these patients?

Wonder how they will categorise it. Will it be people on certain meds perhaps.
Well OP, you posted the link to Rethink.org. Didn't you actually read it?

The link you posted states:
For the purposes of the vaccination, Public Health England say that people who live with severe mental illness are:

“Individuals with schizophrenia or bipolar disorder, or any mental illness that causes severe functional impairment.”

We will update this information when we know more about exactly who with severe mental illness will be offered the vaccine and how they’ll be offered it.

It will be straightforward enough to know who has a diagnosis of schizophrenia or bipolar disorder. Those with a MI causing severe functional impairment could be determined by whether they are on DLA or PIP.

It’s all so sad, so many people really need the vaccine ASAP but it’s just not possible:(

How would consent work for these patients?
I know quite a few people with severe MH issues. They are not in a continual state of psychosis. They generally have insight and are intelligent so I presume they will be consent in the usual manner.

@trulydelicious

How would consent work for these patients?

It would work in the usual way by assessing capacity, this is done on a situation by situation basis. Most would be able to weigh up pros and cons themselves and have capacity to decide, if they weren't a best needs assessment could happen.

I think it's great I have sever mental health issues not sure of it would be for the vaccine but I have carers, a care co, a therapist and work with another team due to my admissions and everyone is scared about me catching covid not due to how Ill I would be but 2 weeks alone would ruin my mental health even further and they dont think I would get out of it alive. This will be the second for so many people with mental health issues.

@trulydelicious

How would consent work for these patients?

Why would you think that most people with SMI can not consent?

Most live in the community and a lot are intelligent people living good lives. A small proportion will be under section and will have other people making medical decisions for them.

Each GP surgery has a register of those classed as having SMI, there are so many more people with mental health conditions such as severe unipolar depression or a diagnosis of personality disorder who would also benefit though.

They will be in priority group 6 which is broadly the under 65 'flu' group. Unpaid carers are also in that group.

@Gingerkittykat

Why would you think that most people with SMI can not consent

Apologies if it read that way, I didn't mean to say this and I know it's not the case.

A small proportion will be under section and will have other people making medical decisions for them

I worry that these vaccines are so new and that specifically the Pfizer one (the one mentioned by RMI) uses new technology. So I put myself in their shoes and I think I would dread it if I was given this vaccine without having the opportunity to decide for myself.

But I understant this is how things are done.

Also some of the information provided by the RMI on that page looks a bit simplistic e.g.

Public Health England say that there are very few individuals who can’t receive the Pfizer/ BioNTech vaccine

When, for instance last week it was advised that people with allergies do not take the vaccine at least for now. There are not very few people with allergies

Apologies again, I did not mean to upset anyone.

The advice last week was not that people with allergies cannot be offered the vaccine. That’s a simplistic and misleading interpretation of the advice.

The advice was in relation to the risk of anaphylaxis for people with specified allergic conditions and treatment requirements. These are known and identifiable in people under NHS care. Basically all of the people being selected and offered the vaccine including people with MH conditions.

@LemonTT

www.bmj.com/content/371/bmj.m4780

People who have a history of a significant allergic reaction to a vaccine, medicine, or food or who have been advised to carry an adrenaline autoinjector should not receive the Pfizer/BioNtech covid-19 vaccine, the UK’s medicine regulator has said

Covid spreads v quickly in institutions and patients with severe mental health issues cant cope with things like needing to be put on oxygen because they dont fully understand what's happening and can't easily be managed in a hospital situation as a result if they get covid.

So by severe mental health issues you are looking in that kind of degree of problem.

Eg: Anyone who has very severe autism or is institutionalised.

So at the moment it's not very few individuals

It's an example as to why to me the RMI advice appeared overall a bit simplistic

@RedToothBrush

Yes, I understand Covid infection in this context is bound to be problematic also

Well OP, you posted the link to Rethink.org. Didn't you actually read it?

I apologise- I'm on one of these meds myself and they do have side effects such as concentration problems at times. I don't understand why this board seems so combative at times.

[quote trulydelicious]@LemonTT

www.bmj.com/content/371/bmj.m4780

People who have a history of a significant allergic reaction to a vaccine, medicine, or food or who have been advised to carry an adrenaline autoinjector should not receive the Pfizer/BioNtech covid-19 vaccine, the UK’s medicine regulator has said[/quote]
Did the BMJ say that or the regulator. I know which guidance I read.