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COVID-19 ethnic inequalities in mental health and multimorbidities: protocol for the COVEIMM study

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)2511-2521
Number of pages11
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number12
Early online date23 Jun 2022
Accepted/In press5 May 2022
E-pub ahead of print23 Jun 2022
PublishedDec 2022

Bibliographical note

Funding Information: This project (“Ethnic inequalities in mortality and service use in people with mental disorders and multimorbidities during the COVID-19 pandemic (COVEIMM study)”, award reference: 2238180) is funded by the Health Foundation’s COVID-19 research priorities programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. EI, JO, R.Stuart and HD were funded by the Health Foundation. JD is part supported by the ESRC Centre for Society and Mental Health at King’s College London (ESRC Reference: ES/S012567/1). JO and JD are also both supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. MH, RS, AD and JD are supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. LB is supported by the Nuffield Foundation (WEL/43881), the ESRC (ES/V013475/1; ES/W000849/1), and the Health Foundation (AIMS 1874695). The views expressed are those of the author[s] and not necessarily those of the ESRC, NIHR, the Department of Health and Social Care or King’s College London. Publisher Copyright: © 2022, The Author(s).


King's Authors


Purpose: The COVID-19 pandemic may have exacerbated ethnic health inequalities, particularly in people with multiple long-term health conditions, the interplay with mental health is unclear. This study investigates the impact of the pandemic on the association of ethnicity and multimorbidity with mortality/service use among adults, in people living with severe mental illnesses (SMI). Methods: This study will utilise secondary mental healthcare records via the Clinical Record Interactive Search (CRIS) and nationally representative primary care records through the Clinical Practice Interactive Research Database (CPRD). Quasi-experimental designs will be employed to quantify the impact of COVID-19 on mental health service use and excess mortality by ethnicity, in people living with severe mental health conditions. Up to 50 qualitative interviews will also be conducted, co-produced with peer researchers; findings will be synthesised with quantitative insights to provide in-depth understanding of observed associations. Results: 81,483 people in CRIS with schizophrenia spectrum, bipolar or affective disorder diagnoses, were alive from 1st January 2019. Psychiatric multimorbidities in the CRIS sample were comorbid somatoform disorders (30%), substance use disorders (14%) and personality disorders (12%). In CPRD, of 678,842 individuals with a prior probable diagnosis of COVID-19, 1.1% (N = 7493) had an SMI diagnosis. People in the SMI group were more likely to die (9% versus 2% in the non-SMI sample) and were more likely to have mental and physical multimorbidities. Conclusion: The effect of COVID-19 on people from minority ethnic backgrounds with SMI and multimorbidities remains under-studied. The present mixed methods study aims to address this gap.

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