Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Apr 19, 2021; 11(4): 94-108
Published online Apr 19, 2021. doi: 10.5498/wjp.v11.i4.94
Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic
Ailyn Diaz, Ritika Baweja, Jessica K Bonatakis, Raman Baweja
Ailyn Diaz, Ritika Baweja, Jessica K Bonatakis, Raman Baweja, Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, Hershey, PA 17033, United States
Author contributions: Diaz A conceptualized this paper, draft the initial manuscript, reviewed and revised the manuscript; Baweja R and Bonatakis JK contributed in the initial manuscript, reviewed and revised the manuscript; Baweja R conceptualized this paper, contributed in the initial manuscript, critically reviewed and revised the manuscript; all authors approved the final manuscript as submitted and agree to accountable for all aspect of the work.
Conflict-of-interest statement: All authors report no conflicts of interest related to the subject of this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Raman Baweja, MD, MS, Associate Professor, Department of Psychiatry and Behavioral Health, Penn State University College of Medicine, 500 University Drive, H073, Hershey, PA 17033, United States.
Received: February 17, 2021
Peer-review started: February 17, 2021
First decision: March 16, 2021
Revised: March 30, 2021
Accepted: April 5, 2021
Article in press: April 5, 2021
Published online: April 19, 2021

The coronavirus disease 2019 pandemic affects psychiatric patients disproportionately compared to the general population. In this narrative review, we examine the impact of the pandemic on significant global health disparities affecting vulnerable populations of psychiatric patients: People of diverse ethnic background and color, children with disabilities, sexual and gender minorities, pregnant women, mature adults, and those patients living in urban and rural communities. The identified disparities cause worsened mental health outcomes placing psychiatric patients at higher risk for depression, anxiety and posttraumatic stress disorder symptoms. Those psychiatric patients who are ethnic minorities display barriers to care, including collective trauma and structural racism. Sexual and gender minorities with mental illness face discrimination and limited access to treatment. Pregnant women with psychiatric diagnoses show higher exposure to domestic violence. Children with disabilities face a higher risk of worsening behavior. Mature adults with psychiatric problems show depression due to social isolation. Psychiatric patients who live in urban communities face pollutants and overcrowding compared to those living in rural communities, which face limited access to telehealth services. We suggest that social programs that decrease discrimination, enhance communal resilience, and help overcome systemic barriers of care should be developed to decrease global health disparities in vulnerable population.

Keywords: COVID-19, Pandemic, Health disparities, Global disparities, Mental health disparities, Access to care

Core Tip: During the coronavirus disease 2019 (COVID-19) pandemic, many psychiatric patients encounter limited access to care due to major health disparities. In this minireview, we examine the impact of the COVID-19 pandemic on vulnerable psychiatric populations due to ethnic-racial disparities, disparities involving children with disabilities, the role of sex and gender trauma in the mental health in sexual and gender minorities, disparities among pregnant women, disparities among mature adults, and the impact in urban vs rural populations.