The Link Between Mental Health Struggles and Severe COVID-19 Outcomes

How to handle stress as the pandemic continues

By Jenna Schifferle

With the spread of the omicron variant comes a renewed concern for mental health.

The pervasiveness of the virus adds a new level of complexity to the struggles many people have faced since the pandemic took hold nearly two years ago.

But what about the way mental health impacts outcomes for those who contract the virus?

A 2021 study published in the Journal of the American Medical Association by physicians Guillaume Fond, Ph.D., Katlyn Nemani, Damien Etchecopar-Etchart and others, showed that people with mental health disorders experienced poorer outcomes from COVID-19.

The study also drew a correlation between severe mental health disorders and the risk for COVID-19 mortality, particularly in those with schizophrenia and bipolar disorders.

The study examined a wide range of mental health conditions varying from psychiatric, psychotic, mood and personality disorders to anxiety, eating disorders and substance abuse.

Of course, the reasons for this correlation are vast and nuanced and several factors may be at play. For instance, people with mental health disorders often have comorbidities like diabetes or heart disease, the study stated. Along with social and environment factors, these comorbidities may affect how people with mental health disorders fair when they contract COVID-19.

So, what does this mean for people with mental health disorders? Two experts weigh in:

Amy Hequembourg, Ph.D.

Amy Hequembourg is the assistant dean for diversity and inclusion and an associate professor for the School of Nursing at the University at Buffalo. A sociologist by training, her research focuses on health disparities among LGBTQ+ populations with an emphasis on interpersonal violence, sources of minority stress and health risk behaviors among these diverse populations.

Hequembourg views the connection between severe COVID-19 and mental health disorders as only one part of a greater issue.

“Mental and physical health are inexorably intertwined and the most vulnerable of our society are [at] greatest risk for severe COVID-19 symptoms,” Hequembourg wrote in an email statement.

When asked about the reasons for the link between severe COVID-19 outcomes and mental health, Hequembourg said that pre-existing conditions, a person’s vulnerability to adverse outcomes and socioeconomic factors can all affect how someone will fair when it comes to being affected by an illness like COVID-19. Particularly susceptible are those groups that were vulnerable before the pandemic, like minorities and LGBTQ+ individuals.

“[The LGBTQ+] population experiences unique stressors related to negative social perceptions about them that adversely impact their health,” Hequembourg wrote.

With the pandemic has also come a great deal of stress on frontline healthcare workers, she added. Caring for sick or dying COVID-19 patients and navigating patients’ families can cause emotional trauma that creates mental health concerns. This is all part of a greater need for federal funding to promote careers in the health field and improved access to health services to support more people, including marginalized groups.

On an individual level, regular exercise, a healthy diet and seeking support from family, friends or coworkers are important self-care strategies for anyone struggling, Hequembourg said. Avoiding media overconsumption, misinformation and social nihilism are equally critical, even when taking these steps proves difficult.

Learn more about Hequembourg’s research at

Erin M. Moss, LMHC

Erin M. Moss, a licensed mental health counselor at Erin M. Moss Mental Health Counseling private practice in Buffalo, has been in the counseling field for 15 years. After reviewing the study from the Journal of the American Medical Association, she said she wasn’t surprised to hear about the link between severe COVID-19 outcomes and mental health.

“What we know is that mental health and physical health are linked. We see that even outside of COVID-19. A lot of times, when people have mental health issues, they also suffer from chronic pain or other physical illnesses,” she said.

Moss added that if someone living with a mental health disorder contracts COVID-19, they’re prone to be impacted by it more because of the mind-body connection, physical illness can worsen mental illness and vice versa. The issue is also further complicated by the social determinants of health or factors that impact one’s ability to properly care for their health (i.e., economic stability, access to quality education and health care, community support, and environment).

“Social inequalities lead to poorer mental health. We have to turn our attention to those populations and make sure that people who are lacking have proper support,” Moss said.

Moss went on to say that these issues haven’t become any less pressing just because the pandemic is approaching the two-year mark. We’re seeing a surge in the omicron variant, which serves as a reminder that this pandemic hasn’t gone away.

“While people may have gotten used to living in a world with COVID-19, we should all continue to take the pandemic seriously,” Moss added. “This means taking precautions like mask-wearing, extra handwashing and talking to your doctor about what’s best for your mind and body.”

For those who are hesitant to get vaccinated, Moss encourages having conversations with a physician to learn more.

Lastly, Moss had a message for anyone who is struggling.

“Look at ways to acclimate and live during this time of COVID-19. Learn how to take care of yourself at home and to adjust the activities you do in your day-to-day life,” she said. “Most importantly, ask yourself: What can I do to inspire hope? What can I do to encourage myself and remember that tomorrow’s a new day? Because it is.”

Learn more about Moss on her website at