Research prompts vaccine priority rethink

People with mental health and addiction issues are now included as a priority group for the Covid-19 vaccine, after evidence was given to Government urging them to recognise the physical health vulnerability of the group.

A key piece of research that helped to inform this decision has been released in the New Zealand Medical Journal today.

Entitled Addressing structural discrimination: prioritising people with mental health and addiction issues during the Covid-19 pandemic, it makes for sobering reading.

Authored by an expert advisory group convened by Equally Well, the paper outlines significantly early mortality rates among those who are in contact with secondary mental health and addiction services. On average, the mortality of this group is 10 – 15 years earlier than the rest of the population, equivalent to life expectancy seventy years ago.

Two thirds of these premature deaths are due to preventable and treatable physical health conditions, such as cancers and heart disease.

Structural discrimination, where the policies and practices of health care organisations produces inequitable access, was identified as a contributing factor in the lower quality of healthcare and increased risk to this group of serious yet preventable illness.

The paper concluded that considering the well-documented vulnerability of the group, mental health and addiction issues should be recognised as underlying health conditions that increase Covid-19 vulnerability and that people with those issues should be prioritised for vaccination.

As a result of this input, which included data from Covid-19 affected countries overseas, people “diagnosed with a severe mental illness (which includes schizophrenia, major depressive disorder, bipolar disorder or schizoaffective disorder), and adults currently accessing secondary and tertiary mental health and addiction services” have been added to Group 3, comprised of people who are at risk of getting very sick from Covid-19.

This recognition is a significant change, and hopefully marks the beginning of further systemic change to address the health inequities people with mental health and addiction issues face across the health system.

Further Information

• The full paper can be accessed through this link: https://www.nzma.org.nz/journal-articles/addressing-structural-discrimination-prioritising-people-with-mental-health-and-addiction-issues-during-the-covid-19-pandemic-open-access
• Equally Well is a collaborative of people and organisations across Aotearoa working together to achieve physical health equity for people with mental health and addiction issues. A group of Equally Well lived-experience, academic and clinical champions came together to appraise the available evidence on Covid-19 vulnerability for people with mental health and addiction issues. The review of the evidence was conducted by Te Pou, a national workforce centre for mental health, addiction and disability in Aoteaora New Zealand.

The following co-authored this paper:

• Helen Lockett: Strategic Policy Advisor, the Wise Group, Hamilton; Honorary Senior Research Fellow, Department of Public Health, University of Otago, Wellington – Te Whare Wānanga o Otāgo ki Poneke, Wellington; Honorary Research Fellow, Department of Psychological Medicine, University of Auckland – Te Whare Wānanga o Tāmaki Makaurau, Auckland.
• Ashley Koning: Principal Advisor Addiction, Te Pou, Auckland.
• Cameron Lacey (Te Atiawa): Senior Lecturer, Māori Indigenous Health Institute (MIHI), University of Otago, Christchurch – Te Whare Wānanga o Otāgo ki Ōtautahi, Christchurch
• Susanna Every-Palmer: Head of Department, Department of Psychological Medicine, University of Otago, Wellington – Te Whare Wānanga o Otāgo ki Poneke, Wellington.
• Kate M Scott: Head of Department, Department of Psychological Medicine, University of Otago – Te Whare Wānanga o Otāgo, Dunedin.
• Ruth Cunningham: Senior Research Fellow, Director EleMent Research Group, Department of Public Health, University of Otago, Wellington – Te Whare Wānanga o Otāgo ki Poneke, Wellington.
• Tony Dowell: Professor of Primary Health Care and General Practice, University of Otago, Wellington – Te Whare Wānanga o Otāgo ki Poneke, Wellington.
• Linda Smith: Consumer Advisor, Canterbury District Health Board – Te Poari Hauora ō Waitaha, Christchurch.
• Alison Masters: Medical Director, Mental Health, Addictions & Intellectual Disability Service – Te-Upoko-me-te-Karu-o-Te-Ika, Wellington.
• Arran Culver: Chief Clinical Advisor, Ministry of Health – Manatū Hauora, Wellington.
• Stephen Chambers: Professor (Pathology), Department of Pathology and Biomedical Science, University of Otago, Christchurch – Te Whare Wānanga o Otāgo ki Ōtautahi, Christchurch.