Abstract
The COVID-19 pandemic has put the UK's National Health Service under extreme pressure, and acute psychiatric services have had to rapidly adapt to a new way of working. This editorial describes the experience of a London psychiatric intensive care unit (PICU) where all nine in-patients ultimately tested COVID-19 positive.
Highlights
The management of behavioural disturbance in the context of COVID-19 was challenging because of additional risks, which included: non-adherence to self-isolation procedures and physical health monitoring, the need for interventions such as restraint, rapid tranquillisation and one-to-one nursing
At the time of writing London is an epicentre for the COVID-19 outbreak in the UK, other acute mental health units will soon be facing similar situations, so it is important to share what has been learnt
All nine patients in this psychiatric intensive care unit (PICU) tested positive for COVID-19: two had severe illness, with one requiring transfer to an acute hospital for treatment
Summary
The management of behavioural disturbance in the context of COVID-19 was challenging because of additional risks, which included: non-adherence to self-isolation procedures and physical health monitoring, the need for interventions such as restraint, rapid tranquillisation and one-to-one nursing. COVID-19 presents a unique challenge to the in-patient psychiatry setting owing to the nature of psychiatric illness and its treatment. Patients who require care in a PICU are in an acutely disturbed phase of a serious mental disorder where the associated risks – to self and others – cannot be safely managed on an acute ward.
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