Calling on States to Include Individuals in Psychiatric Hospitals for Priority Vaccination

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On December 3, 2020, the CDC Advisory Committee on Immunization Practices issued recommendations for allocating initial supplies of COVID-19 vaccine. It recommended that the first groups to receive vaccines be health care workers, including hospital staff, and residents of “long-term care facilities” including nursing homes and assisted living facilities. Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020,

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6949e1-H.pdf.

The Committee’s recommendations do not directly address whether psychiatric inpatients are or should be included among those first to receive the vaccine (Phase 1A). However, the Committee did make clear that “Health care settings in general [such as hospitals], and long-term care settings in particular, can be high-risk locations for SARS-CoV-2 exposure and transmission.” Id.

Many psychiatric inpatients, including most psychiatric inpatients in general hospitals, will be discharged after a relatively short stay. In the allocation of vaccines, inpatient psychiatric patients who are likely to be discharged after a short stay should receive the same priority for vaccination as other hospital patients.

Many psychiatric inpatients, however, especially those in state and other public hospitals, will experience stays of weeks and months. In the allocation of vaccines, these patients should have the same priority for vaccination as residents of other longer-term congregate care facilities, such as nursing homes and assisted living facilities.

Hospital discharge plans should identify how a second dose of the vaccine will be administered if the second does has not been received by the time of discharge.

Accordingly, to implement the CDC’s recommendations, state authorities making vaccine allocation decisions should:

1. Include psychiatric inpatients whose hospital stay is likely to be weeks or months in the first group to receive the vaccine (phase 1a).

2. Give short-term psychiatric inpatients the same priority as other hospital inpatients.

3. Require that hospital discharge plans provide for the administration of a second dose of the vaccine.

We also urge state authorities to follow guidance from SAMSHA concerning limiting psychiatric inpatient stays during the pandemic.

https://www.samhsa.gov/sites/default/files/considerations-care-treatment-mental-substance-use-disorders-covid19.pdf

National Association of State Mental Health Program Directors

American Psychological Association

Judge David L. Bazelon Center for Mental Health Law

Mental Health America

National Alliance on Mental Illness

It's Objectives Achieved, the Wilkes Case is Dismissed

Middletown, Connecticut. January 13, 2021. The case of Wilkes v. Lamont was filed in response to Covid deaths and unsafe conditions in two of Connecticut’s state psychiatric hospitals, Connecticut Valley Hospital and Whiting Forensic Hospital. In the spring COVID surge, five patients died and scores of patients and staff were infected.

The Plaintiffs, five hospital patients, asked the U.S. District Court to require state officials, including the Governor, to improve infection control at the hospitals, limit admissions, and accelerate discharges. The plaintiffs are represented by the Connecticut Legal Rights Project (CLRP), the Bazelon Center for Mental Health Law, and the Center for Public Representation.

The goals of the case have largely been achieved. We thank the Governor and the Department of Mental Health and Addiction Services for improved safety protocols at the hospitals and getting the Covid outbreaks at the hospitals under control. We also thank the Governor’s COVID-19 Vaccine Advisory Group for recognizing that individuals in state psychiatric hospitals should be vaccinated on a priority basis.

Because the Plaintiffs and the class they sought to represent will soon be vaccinated, today the Wilkes case was dismissed.

The pandemic has amplified concerns about Connecticut’s over-reliance on institutions and statewide deficiencies in community services for people with mental illness. CLRP and its partners plan to continue to address these issues in ongoing advocacy.

For further information, please contact:

Kathy Flaherty, Connecticut Legal Rights Project, kflaherty@clrp.org, (860) 262-5030

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