The Use of Telemedicine for Patients with Mental Illness and COVID-19 Infection

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the health of the public. Social distancing and quarantining during the pandemic have affected mental health as well. This study set out to determine the impact of COVID-19 and the use of telemedicine on managing patients with mental illness. It evaluates the impact of the COVID-19 infection on 403 patients who are United States military veterans: 160 patients with chronic mental illnesses and 243 without mental illness. The patients were observed remotely using a telehealth clinic until they were free of COVID-19 symptoms or tested negative for coronavirus RNA. Telemedicine was used successfully to manage patients with mental illness and acute COVID-19 infections. These patients maintained their therapeutic engagement using telephone or video-on-demand encounters. The use of this technology allowed for follow-up visits over an extended period of time, including resolution of their symptoms, re-test results, and management of their comorbidities. The outcomes of their infections mirrored those of patients without preexisting mental illness. They did require more intense psychiatric interventions, primarily with medications, but no hospitalizations for mental health occurred. Although the pandemic has several elements known to impact greatly on mental health (social illness, loneliness, fear, and uncertainty), the effect on patients with COVID-19 infection and mental illness diagnosis does not appear to cause psychiatric decompensation. Telemedicine offered a means for more intense engagement on follow-up of these patients, which may have played a role. Because of the small numbers in this study and the unique resources available for veterans, more extensive study is required to determine the effect of the pandemic in patients with mental illness who are not veterans.