Consultation liaison psychiatry for COVID-19 inpatients: A novel care delivery program in Morocco
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Consultation liaison psychiatry for COVID-19 inpatients: A novel care delivery program in Morocco Roukaya Benjelloun 1 & Yassine Otheman 2
&
Chafik El Kettani 1
Accepted: 13 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Introduction Since its onset in late 2019, the COVID-19 outbreak has become a worldwide medical crisis, declared as a public health emergency of international concern by the World Health Organization (WHO) on January 30th, 2020 (Wang et al., 2019). Mental health is considered a major issue during this health worldwide crisis (Asdmunson, 2020); while data on mental health issues in COVID-19 inpatients are more and more available (Hu et al., 2020). Here we report results of a novel care delivery program in the current context of COVID19 outbreak, in Cheikh Khalifa University Hospital in Casablanca, Morocco.
Description of the Mental Health Circuit for COVID-19 Inpatients We set up protocols and specific tools to implement a psychiatric support system facilitating the intervention of physicians assigned to the COVID-19 ward:
Information Sheet for Patients and Psychotropic Drug Protocol for Physicians Noticing that patient’s distress was considerably fueled by the ignorance of « what was going on for them », we elaborated an information sheet that contains specific information related to the COVID-19 unit routines as well as WHO recommendations about sleep and stress management (https://www.who.int/ * Yassine Otheman [email protected] 1
Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
2
Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
publications-detail/WHO-2019-nCoV-MentalHealth-2020.1, n.d.). We also elaborated guidelines for managing acute insomnia, anxiety, and psychiatric agitation for the first line physicians, looking after the COVID-19 ward. We mentioned drugs to avoid regarding their interactions with hydroxy-chloroquine and azithromycine association, recommended anxiolytics and hypnotics with short half-lives, at lower doses and for short durations and we conditioned the prescription of antipsychotics by a previous cardiac assessment.
Psychiatric Interventions for COVID-19 Inpatients Depending on the severity of their initial symptoms, patients with COVID-19 were admitted either in regular rooms, intensive care unit or resuscitation ward. We systematically assessed patients initially admitted in regular rooms or intensive care unit within two days following their admission. Further assessments by telephone were scheduled for symptomatic patients for whom we indicated a specific intervention, at patients’ demand or when medical staff noticed that patients showed symptoms of psychological distress. The psychiatric evaluation of patients initially admitted in resuscitation ward was previously conditioned by the authorization of the resuscitation staff following a case by case assessment. We decided to run our first interviews face to face for two main reasons:
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