RESEARCH WEEKLY: 2020 Top 10 List of Severe Mental Illness Research 

By The Office of Research and Public Affairs

Reflecting on 2020, we at the Office of Research and Public Affairs (ORPA) have put together our list of top 10 research published this year about severe mental illness. The list includes commentary on our favorite published research from each of the ORPA team members who brought Research Weekly to your inbox every week throughout 2020. Much like looking forward to 2021 after the COVID-19 pandemic dominated much of our lives in 2020, this list focuses on the impact of the research findings for people with severe mental illness, their families and loved ones for the future.  

ORPA has produced original research on the role and impact of serious mental illness on public service systems, including the role of mental illness in fatal law enforcement encounters and the dwindling supply of psychiatric hospital beds. Filling the informational void around severe mental illness by making relevant research accessible to family members, policymakers, clinicians, media and the general public is also central to our mission. 

Here is our top 10: 

Prioritize SMI for COVID-19 vaccine – International researchers argue that people with severe mental illness should be prioritized for the COVID-19 vaccine because of their increased vulnerability to the virus in an article published in World Psychiatry earlier this year. People with severe mental illness are at heightened risk for serious illness and death if infected with COVID-19, in part due to comorbid physical health conditions, which we wrote about early on in the pandemic. As the discussions around who should be prioritized for the limited availability of vaccine allocations continues into 2021, we will continue to educate and bring awareness to the impact of COVID-19 on people with severe mental illness and their families and loved ones. -- EH 

SAMHSA AOT report findings  The Substance Abuse and Mental Health Services Administration (SAMHSA) released findings from the first two years of their Assisted Outpatient Treatment (AOT) grant program in 18 different locations across the United States. The initial findings suggest AOT is beneficial in many different areas of interest, including reducing hospitalizations, emergency department visits, arrest rates and homelessness, all while receiving favorable reviews from participants; see our highlights from the report here. These findings contribute to the existing body of literature that shows AOT’s positive impacts on individuals living with severe mental illness and their ability to live fulfilling lives in their communities, removing them from the revolving door of arrests and hospitalizations. -- KS 

Co-occurring SMI and substance use disorders – A September Research Weekly featured evidence that methadone maintenance treatment is effective for those with an opioid use disorder and severe mental illness. Detailed in our upcoming 2021 brief on co-occurring disorders, people with severe mental illness are often left out of research about drug use treatment. People wrongly assume that those with severe mental illness won’t benefit from medication assisted drug treatment programs, but research has shown this to be false. This research, and others like it, provide hope for those facing both drug use disorders and severe mental illness. -- MV 

Intersection of race and serious mental illness in crisis response – 2020 saw a major resurgence of racial justice protests, which reached a boiling point after a video of law enforcement officers killing George Floyd was publicized. Race and mental illness intersect when it comes to law enforcement’s response to crisis calls; we highlighted the barriers surrounding law enforcement response to those with severe mental illness in a June Research Weekly post. As our own legislative and policy counsel Sabah Muhammad wrote in an op-ed for The Washington Post this year, when responding to a crisis call for a Black person with a serious mental illness, “officers too often perceive a dangerous Black criminal and not a sick human being, increasing the probability that deadly force will be used.” -- KS 

Establishment of 9-8-8 as mental health crisis hotline  On Oct. 17, 2020, the National Suicide Hotline Designation Act was signed into law. This follows the FCC’s designation of a 3-digit number to replace the existing suicide hotline number (1-800-273-8255) and provides additional resources to the crisis call centers. Suicide rates among those with severe mental illness are higher than the general population, and hotlines can be a vital pathway to connecting individuals with crisis resources. As the new phone number goes into effect during the next two years, effectiveness research and evaluations should ensure that people with severe mental illness are benefiting from the improved crisis care and hotline system. -- MV 

COVID-19 impact on psychiatric services  COVID-19 has upended all aspects of life in 2020, including the availability and delivery of mental health services to people with severe mental illness. Important scholarship was published in 2020 regarding new modes of delivery of psychiatric care to people with serious mental illness, such as the acceptability and challenges of telemedicine. Perhaps the most influential report was an investigation published in the Wall Street Journal by reporter Shalini Ramachandran on how COVID-19 has shrunk the already limited supply of psychiatric beds. Focus should be paid in 2021 to expanding the psychiatric treatment capacity to meet demand, and in ensuring equitable access to mental health treatment for all who need it. -- EH 

New treatments and research at the NIMH – The 2020 National Institute of Mental Health Strategic Plan lays out the institution’s research goals and priorities for the next five years. Despite public comments from the Treatment Advocacy Center and others, the plan largely leaves out research about severe mental illness. NIMH’s research investments focus on research that, according to a new report published by Drs. E. Fuller Torrey, John Rush, and Michael Knable, is unlikely to result in benefits for people with severe mental illness in the next 20 years. Instead, ORPA encourages research into new treatments, such as the one’s detailed in Research Weekly earlier this year which can lead to better medications to treat severe mental illness symptoms with fewer side effects. -- MV 

Psychiatric effects of the COVID-19 pandemic – There is no question that there will be psychiatric effects as a result of the COVID-19 pandemic. Past evidence also suggests that there may be new incidence of psychosis and an increased prevalence of severe mental illness in future years due to the physiological effects of viral infection from on the brain, as coronaviruses can invade nerve cells. As we highlighted in our Fall 2020 edition of Catalyst, research by Treatment Advocacy Center board member Dr. Robert Yolken and his colleague Dr. Faith Dickerson published in 2011 found that patients with recent onset psychosis were more likely to have an immune system response to different types of coronaviruses. This research is a foundational bedrock to future studies regarding COVID-19 infection and development of severe mental illness. -- EH 

New findings in the criminal justice arena – New research published this year shed light on various aspects of the involvement of individuals with a serious mental illness in the criminal justice system. We featured a number of criminal justice related articles in Research Weekly this year, including one that discussed the negative impacts of the Federal Medicaid Inmate Exclusion Policy (MIEP) on incarcerated individuals with serious mental illness. Findings released from the National Association of Counties and National Sherriff’s Association show that the MIEP reduces access to mental health services and other healthcare while increasing the likelihood of recidivism for some jailed individuals. People with serious mental illness are overrepresented in the criminal justice system, so it is extremely important to call attention to policies that negatively affect their experience within the system and examine more ways to divert this group from the system in the first place. -- KS 

Need for more research – Rounding out our research top 10 list is not a published work, but rather the lack thereof. Enormous gaps still remain in our knowledge about severe mental illness with much research work to be done. As we wrote earlier this year, research into severe mental illness is more important now than ever. -- EH 
 
Wishing you and your loved ones a safe, happy and healthy new year! 
Elizabeth Hancq is the director of research. Kelli South is the research assistant; Molly Vencel is the research intern.  

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Questions? Contact us at orpa@treatmentadvocacycenter.org 

Research Weekly is a summary published as a public service of the Treatment Advocacy Center and does not necessarily reflect the findings or positions of the organization or its staff. Full access to research summarized may require a fee or paid subscription to the publications.  

The Treatment Advocacy Center does not solicit or accept funds from pharmaceutical companies.