Caring for patients in mental health services during COVID-19 outbreak in China
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(2020) 19:66 Hou et al. Ann Gen Psychiatry https://doi.org/10.1186/s12991-020-00317-z
Open Access
COMMENTARY
Caring for patients in mental health services during COVID‑19 outbreak in China Ruihua Hou1* , Limin Yang2, Zhen Tang3 and Teng Chen4
Abstract This article reflects on some radical changes made in mental health services in China which include the implementation of the initial triage system and the special isolation ward, the early screening and testing for both patients and staff, the smaller teams working on rotating shifts on-site, and the adequate provision of PPE. These measures would be of great value as a reference to the effective delivery of mental health services in other countries through this pandemic. Keywords: COVID-19, Mental health services, Psychiatry, Isolation, Testing Background The World Health Organization has declared COVID-19 a “public health emergency” [1]. With 173 million people living with mental disorders in China [2], the COVID19 outbreak has posed an emerging challenge for mental health services in China [3]. Following the report of a cluster of 50 cases of COVID19 amongst inpatients in one psychiatric hospital in Wuhan, China, on 9th February, 2020 [4], significant concerns were raised. A statement addressed the prevention and control of COVID-19 in patients with severe mental disorders on 17th February, 2020 [5]. Mental health institutions have since taken a series of mandatory measures to address prevention of nosocomial cross-infection between patients and medical staff during the pandemic period, as well as easing difficulties of access to mental health services. Main text On‑site triage
On-site COVID-19 screening sites have been temporarily set up at entrances of hospitals. This includes using *Correspondence: [email protected] 1 Department of Psychiatry, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK Full list of author information is available at the end of the article
infra-red thermometers to screen for fever in all patients and carers, as well as recording travel and contact histories within known epidemic areas over the past month. Patients are issued with coloured cards to label their potential risk of infection (green indicates low risk; yellow indicates moderate risk; red indicates high risk). Essential personal protective measures are required (such as wearing a mask) at this stage. Admission pathways
Hospitals set up special isolation wards for all new admissions to monitor any COVID-19 symptoms due to the incubation period. After 2 weeks of observations, a negative test for COVID-19 is then required before admission to the non-infected general wards. Stricter measures are introduced to geriatric wards including separation from the rest of the hospital to protect the most vulnerable patients. This pathway is outlined in the flowchart in Fig. 1. Medical staff
All medical staff have weekly COVID-19 virus nucleic acid tests taken with routine daily monitoring of body temperature. In special isolation w
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