The impact of the COVID-19 pandemic on mental health and functional outcomes in Veterans with psychosis or recent homelessness: A 15-month longitudinal study

PLoS One. 2022 Aug 24;17(8):e0273579. doi: 10.1371/journal.pone.0273579. eCollection 2022.

Abstract

Background: The COVID-19 pandemic has had unprecedented effects on mental health and community functioning. Negative effects related to disruption of individuals' social connections may have been more severe for those who had tenuous social connections prior to the pandemic. Veterans who have recently experienced homelessness (RHV) or have a psychotic disorder (PSY) are considered particularly vulnerable because many had poor social connections prior to the pandemic.

Methods: We conducted a 15-month longitudinal study between May 2020 -July 2021 assessing clinical (e.g., depression, anxiety) and community (e.g., social functioning, work functioning) outcomes. Eighty-one PSY, 76 RHV, and 74 Veteran controls (CTL) were interviewed over 5 assessment periods. We assessed changes in mental health and community functioning trajectories relative to pre-pandemic retrospective ratings and examined group differences in these trajectories.

Results: All groups had significantly increased symptoms of depression, anxiety, and concerns with contamination at the onset of the pandemic. However, RHV and PSY showed faster returns to their baseline levels compared to CTL, who took nearly 15 months to return to baseline. With regards to functioning, both RHV and PSY, but not CTL, had significant improvements in family and social networks over time. Work functioning worsened over time only in PSY, and independent living increased over time in both RHV and PSY but not CTL.

Conclusions: These results reveal that vulnerable Veterans with access to VA mental health and case management services exhibited lower negative impacts of the COVID-19 pandemic on mental health and community functioning than expected.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • COVID-19* / epidemiology
  • Humans
  • Ill-Housed Persons*
  • Longitudinal Studies
  • Mental Health
  • Pandemics
  • Psychotic Disorders* / diagnosis
  • Psychotic Disorders* / epidemiology
  • Retrospective Studies
  • Veterans* / psychology

Grants and funding

This study was funded by the Research Enhancement Award Program to Enhance Community Integration in Homeless Veterans (MFG) Rehabilitation Research and Development grant D1875-F from the Department of Veteran Affairs, https://www.research.va.gov/, and by the VA National Center on Homelessness among Veterans (MFG), https://www.va.gov/homeless/nchav/index.asp. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.