Mental health units facing ‘care home style crisis’ without better protection from COVID-19

The COVID-19 crisis sweeping across care homes could be replicated in mental health care unless access to testing kits and PPE dramatically improves, warns the President of the Royal College of Psychiatrists.

Thousands of psychiatrists and frontline staff are still treating people with mental illness face-to-face, either in the community or in inpatient settings – such as specialist eating disorder units and liaison services – and are at increased risk of contracting or passing on COVID-19.

The College’s warning comes as their national survey found only half of psychiatrists confirm they can access testing kits for themselves (51%) or their patients (54%), while less than one in three (30%) confirmed they can obtain tests for family members.

Professor Wendy Burn, president of the Royal College of Psychiatrists, said: “The findings of our survey are deeply worrying, with many psychiatrists unable to test their patients or themselves in line with official advice.

“Without access to testing kits and the right protective equipment I fear we could see a care home style crisis sweeping through mental health units, with many patients and staff contracting the virus.

“Care homes have been left behind during the pandemic. The government must ensure the same does not happen to mental health services.”

Despite official guidance that they should have access to protective equipment the results of the survey also show:

  • Nearly one in four (23%) psychiatrists in the UK don’t have access to correct PPE
  • Scotland (29%), Wales (28%) and Northern Ireland (26%) worse than UK figure
  • More than one in five (22%) psychiatrists in England working without correct PPE

Dr Adrian James, registrar of the College, added: Dr Adrian James, registrar of the College, added: “A patient with or at risk of contracting COVID-19 is the same in all healthcare settings and they should be treated the same.

“Not all our buildings are set up to withstand infection control and we’re hearing some real fear from our frontline psychiatrists who are putting themselves and their families in danger every time they go to work.

“Government must urgently address the need in mental health services to ensure staff and patients have the protection they need from the virus.”

Written responses to the survey from psychiatrists working on the frontline include:

“Last week we did CPR on a patient who had hung themselves with no fit tested PPE.”

“There are extreme shortages of PPE and most of us are at risk. Only very limited supply is obtained and most of the time frontline staff are refused risking their lives. Staff are terrified and afraid.”

“Spitting in COVID positive patients is a real issue and not able to get the appropriate PPE, social distancing impossible in inpatient settings.

Dr Agnes Ayton, chair of the eating disorders faculty at the Royal College of Psychiatrists, said: ““Mental health units were ill-prepared to cope with this pandemic as they are not designed to contain a highly contagious disease.

“Our buildings are often crammed with shared computers and offices. Waiting rooms and shared facilities in inpatient settings also makes it difficult to reduce the risk of transmission.

“New patients are arriving for life-saving treatment and we do not know if they are carrying coronavirus as we are unable to test them. We need to be able to access tests if we’re to try to mitigate against COVID-19 amongst our workforce.”

1,685 members responded to the survey which was in the field from Wednesday 15 April – Friday 17 April. Questions were asked on access to PPE, testing kits, duties undertaken at work, time-off during the pandemic and delays in implementing the Mental Health Act.

A summary of the results (PDF) on PPE and testing is available.