Carol Lim, MD, MPH Fellow in Public and Community Psychiatry Massachusetts General Hospital Harvard Medical School Boston, Massachusetts
Manjola U. Van Alphen, MD, PhD, MBA Chief Medical Officer North Suffolk Mental Health Association Instructor in Psychiatry MGH Schizophrenia Clinical and Research Program Harvard Medical School Boston, Massachusetts
Oliver Freudenreich, MD, FACLP Co-Director MGH Schizophrenia Clinical and Research Program Director MGH Fellowship in Public and Community Psychiatry Massachusetts General Hospital Associate Professor of Psychiatry Harvard Medical School Boston, Massachusetts
Disclosures Dr. Freudenreich has received research grants (to institution) and consultant honoraria (advisory board) from Janssen (area: schizophrenia, long-acting injectable antipsychotics). Drs. Lim and Van Alphen report no financial relationships with any companies whose products are mentioned in this article, or with manufacturers of competing products.
The active involvement of psychiatrists in COVID-19 vaccination efforts can protect patients from the virus, reduce health disparities among patients with SMI, and promote herd immunity, helping to end the pandemic. Psychiatry practices can serve as ideal platforms to deliver evidence-based COVID-19 vaccine information and encourage vaccine uptake, particularly for marginalized populations.
Vaccination programs in mental health practices can even be conceptualized as a moral mandate in the spirit of addressing distributive injustice. The population management challenges of individual-level barriers and follow-through could be dramatically reduced—if not nearly eliminated—through policy-level changes that allow vaccinations to be administered in places where patients with SMI are already engaged: that is, “shots in arms” in mental health settings. As noted, some studies have shown that mental health settings can play a key role in other preventive care campaigns, such as the annual influenza and hepatitis vaccinations, and thus the incorporation of preventive care need not be limited to just COVID-19 vaccination efforts.
The COVID-19 pandemic is an opportunity to rethink the role of psychiatrists and psychiatric offices and clinics in preventive health care. The health risks and disparities of patients with SMI require the proactive involvement of psychiatrists at both the level of their individual patients and at the federal and state levels to advocate for policy changes that can benefit these populations. Overall, psychiatrists occupy a special role within the medical establishment that enables them to uniquely advocate for patients with SMI and ensure they are not forgotten during the COVID-19 pandemic.
Bottom Line
Psychiatrists could apply behavior management techniques such as motivational interviewing and nudging to address vaccine hesitancy in their patients and move them to accepting the COVID-19 vaccination. This could be particularly valuable for patients with serious mental illness, who face increased risks from COVID-19 and additional barriers to getting vaccinated.
