RESEARCH WEEKLY: COVID-19 and Inpatient Psychiatric Hospitals
As accounts of COVID-19 devastating inpatient psychiatric hospitals throughout the country are reported almost daily, more solutions are needed to prevent further tragedy to this vulnerable population.
Inpatient psychiatric care is a vital component to the continuum of care for people with mental illness. This is now especially true with outpatient services having limited operations, medication access is inadequate and clubhouses or other day programs have closed their doors. Yet, the challenges of COVID-19 are different for inpatient psychiatric hospitals. In these settings, isolation can be dangerous while social interaction is not a luxury, but lifesaving.
Psychiatrist Dr. Luming Li from Yale School of Medicine published an article in Psychiatric Services earlier this month discussing the specific challenges of addressing an infectious disease pandemic in an inpatient psychiatric setting and provided five planning considerations for hospitals in responding to COVID-19.
Dr. Li suggests that responding to COVID-19 in an inpatient psychiatric setting requires clear communication and organized leadership. Importantly, she recommends hospital leadership provide daily updates to families and staff to minimize uncertainty and confusion.
Below is a passage from the article, but it is also available for free on the Psychiatric Services website.
“Inpatient psychiatric settings present unique challenges due to open space units, patient population, close contact for treatment. IN many psychiatric units, patients are free to move and interact with other patients. It can be difficult to isolate patients with behavioral dysregulation from symptoms of active mania and psychosis. In addition, staff are in close contact with patients, with regulatory requirements to visualize patients every 15 minutes and preform safety checks. Patients and clinical staff have therapeutic interactions multiple times per day for rounding and examinations. In addition, basic structural challenges also exist for infection prevention in psychiatric facilities. For example, psychiatric facilities can include shared bathrooms and non-alcohol-based hand-sanitizer due to safety precautions. Handwashing per recommendations can be a difficult task, as some psychiatric patients have poor hygiene and limited ability to comprehend directions due to psychiatric illness. Psychiatric patients are admitted to a hospital for safety concerns, and therefore cannot be discharged home to self-quarantine if symptoms develop due to COVID-19.”
