The Impact of Omicron on People With Serious Mental Illness

Psych Congress Steering Committee Member, Craig Chepke, MD, FAPA, adjunct associate professor of psychiatry, Atrium Health, adjunct assistant professor of psychiatry, UNC School of Medicine, and medical director, Excel Psychiatric Associates, Huntersville, NC, discusses the outcomes of his paper, “The Post COVID-19 Healthcare Landscape and the Use of Long-Acting Injectable Antipsychotics for Individuals With Schizophrenia and Bipolar I Disorder: The Importance of an Integrated Collaborative-Care Approach.”

Watch Part 2: Treating Serious Mental Illness Through Telehealth

Dr Craig Chepke: Hi, I'm Dr. Craig Chepke. I'm the medical director of Excel Psychiatric Associates in Huntersville, North Carolina. I'm an adjunct assistant professor of psychiatry for the University of North Carolina School of Medicine, and an adjunct associate professor of psychiatry for Atrium Health. I'm also on the steering committee for Psych Congress.

We're going through, in this country, a surge of the Omicron variant of COVID-19 at this point. And it's really bringing us back to the beginning of the pandemic, in some ways, where we had to figure out how do we continue to provide high-quality, in-person care, or transition some part of our care to virtual, especially in patients with severe mental illness (SMI).

As timing would have it, a paper just was published that I was fortunate to be able to participate in. And I'd like to talk a little bit about that today.

So, the paper that I was a co-author on with Dr Christoph Correll, being first author, was published in BMC Psychiatry, and it contains the information that we got as the result of a 2-part process. First, a literature review was done looking at people with severe mental illness in COVID-19, and the amount of data that's has been in the literature up into this point. And then also there was a group roundtable discussion that we conducted with that literature review, but with a very multidisciplinary type of roundtable process. There were physicians, psychiatrists, such as Dr Correll, myself there. Then there were many other stakeholders, including members of patient advocacy groups, like Mental Health America, DBSA the Depression Support Alliance, and a number of other organizations. So we really had a very diverse population of people to discuss these findings.

What we did was we took the results of the literature review, and then combined that evidence basis with our own observations from either clinical care for the clinicians in the room, from their work with peers, from the patient advocacy groups, and our own anecdotal experience, and really try to come up with some recommendations and some conclusions on what it's like to treat people with severe mental illness in the COVID-19 pandemic in general.

But then also more specifically, we wanted to have a narrower focus on the use of long-acting injectable (LAI) antipsychotics. I'm a huge advocate for LAI treatments, as pretty much all of the attendees of that roundtable were, and the pandemic has dealt us a pretty difficult hand with that. There's been a desire to want to reduce in person contact, especially during the surges, as I said, we're currently in now. But there are certain things that can't be done virtually. And LAI is, obviously, being one of those have to be administered in person. So how can we walk that line between providing those necessary and, I would say, LAIs lifesaving treatment for the people with severe mental schizophrenia, and in some cases bipolar I disorder, who receive them, and also maintaining a safety for an infectious disease, point of view with COVID?