Using electronic patient records to assess the impact of swine flu (influenza H1N1) on mental health patients

Background. Electronic patient records are increasingly used in primary care research, but rarely in psychiatric research. Little is known about how people with pre-existing mental illness respond to public health threats. Aims. To outline the swine flu related concerns and behaviours of mental health patients and to determine whether marked concern was associated with any specific demographic or diagnostic groups. Methods. We searched a database containing electronic patient records from a large mental health trust for references to swine flu made between 15 April and 15 July 2009. Thematic analysis was used to code swine flu related concerns and behaviours. A case control approach sought to determine whether there were demographic or diagnostic associations with expressing moderate/severe concern about swine flu. Results. A range of swine flu related behaviours were noted and considerable impact was recorded for some patients. Children and patients with neurotic and somatoform disorders were over-represented amongst those expressing moderate/severe swine flu concerns. Conclusion. Research databases using electronic clinical records are a useful way to track responses to emerging public health threats. Children receiving mental health care and patients with neurotic and somatoform disorders may be particularly psychologically vulnerable to infectious disease epidemics.