The coronavirus disease 2019 (COVID-19) pandemic will present an unprecedented stressor to patients and health care systems across the globe. Because there is currently no vaccine or treatment for the underlying infection, current health efforts are focused on providing prevention and screening, maintaining continuity of treatment for other chronic conditions, and ensuring access to appropriately intensive services for those with the most severe symptoms.¹

Disasters disproportionately affect poor and vulnerable populations, and patients with serious mental illness may be among the hardest hit. High rates of smoking in this population may raise the risk of infection and confer a worse prognosis among those who develop the illness.² Residential instability and homelessness can raise the risk of infection and make it harder to identify, follow up, and treat those who are infected.³ Individuals with serious mental illnesses who are employed may have challenges taking time off from work and may lack sufficient insurance coverage to cover testing or treatment. Small social networks may limit opportunities to obtain support from friends and family members should individuals with serious mental illness become ill. Taken together, these factors may lead to elevated infection rates and worse prognoses in this population.

What strategies are available to mitigate the outcome of this epidemic among patients with serious mental illness? Federal preparedness policies developed in the wake of complex disasters have increasingly embraced the notion of whole community preparedness, which supports building and supporting structures at multiple levels to prepare and respond, particularly for vulnerable populations.⁴ Within the public mental health care system, this includes engagement with mental health service users, clinicians, and federal and state policies.

2019年冠状病毒病（COVID-19）大流行将给全球患者和医疗系统带来前所未有的压力。由于目前尚无针对潜在感染的疫苗或治疗方法，因此当前的卫生工作重点在于提供预防和筛查，为其他慢性病维持治疗的连续性，并确保症状最严重的人获得适当的强化服务。^1个

灾害严重影响着贫困和脆弱人群，患有严重精神疾病的患者可能是受灾最严重的人群。在这一人群中，高吸烟率可能会增加感染的风险，并使患病者的预后更差。²居住区的动荡和无家可归会增加感染的风险，并使人们难以识别，跟进和治疗感染者。³受雇患有严重精神疾病的个人可能会面临休假的挑战，并且可能缺乏足够的保险来覆盖测试或治疗。如果严重的精神疾病患者患病，小型的社交网络可能会限制获得朋友和家人支持的机会。这些因素加在一起可能导致该人群的感染率升高和预后更差。

有什么策略可以减轻严重精神疾病患者的这种流行病的后果？在复杂灾难之后制定的联邦防备政策越来越多地采用了整个社区防备的概念，这支持在多个级别上建立和支持结构以进行准备和应对，特别是针对弱势人群。⁴在公共精神卫生保健系统内，这包括与精神卫生服务用户，临床医生以及联邦和州政策的互动。