Isolation, iPads and High School Musical: The ‘incredible challenge’ of managing a mental health ward during the coronavirus pandemic
PUBLISHED: 16:23 29 May 2020
“Often we just don’t know what we are dealing with.”
Two of the senior management team in charge of the in-patient mental health unit at Northwick Park Hospital have spoken of the “incredible challenge” that has been managing acutely unwell patients during the Covid-19 pandemic.
The Central North West London (CNWL) NHS Trust’s Harrow clinical director Dr Deepti Shah-Armon and deputy director Gail Burrell told the Kilburn Times staff at the unit had adapted remarkably to the unprecedented conditions.
CNWL runs mental health and addiction services across north London and the south-east.
Dr Shah-Armon said: “I have been absolutely blown away by the dedication of staff going above and beyond.
“We have had to make sure our services are safe and effective even with Covid-19 ongoing. It’s really been about making sure the services are all working together.
“We set up an emergency service here so we could get people in as quickly as possible – we have been really trying to support our colleagues by keeping patients away from A&E as much as possible.
Dr Shah-Armon, who lives locally and had her children at Northwick Park, only started in the job earlier this year, having previously headed up CNWL’s addiction services.
“It was around the week Covid hit, I think. What was happening around mental health, I don’t think I could quite believe.”
Ms Burrell added: “It’s been an incredible challenge but the staff have been outstanding.
“The patients that we see coming in are incredibly unwell, so our staff therefore have the challenge of trying to manage really disturbed patients while not knowing if they are Covid positive or negative.
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“When someone is admitted we have to put them into isolation and we have to try to swab them. You can imagine – someone is very unwell, potentially thinking that people are out to get them, and then you want to put a swab in their mouth and nose and ask them to stay in their room.
“It can be just impossible. Often we just don’t know what we are dealing with.”
The pair said their priorities had been making sure patients knew, as much as possible, what was going to happen, and then also to make sure staff had the support they needed.
Ms Burrell added: “A number of our staff have become infected. It has been very tough.”
Dr Shah-Armon said: “We have had patients who were profoundly unwell and people in mental health crises can struggle to follow instructions, they can be aggressive. Even if you have full PPE on it can end up with it flying off – and the staff keep going.”
Both women said the pandemic had brought unique challenges for public mental health.
Telling the story of one patient who had been admitted after losing a job and struggling with a mortgage due to Covid-19, Gail said: “We have seen people come into our service who have never been in touch with mental health services before. People have started off anxious and in this time for some that becomes an extreme form of anxiety.”
On the wards, iPads have been used to help patients stay connected with families, while CNWL’s crisis team have been treating patients in their own homes where possible.
Dr Shah-Armon and Ms Burrell explained they had had to “think creatively” about how to keep staff and patients safe, and this had even included morning singalongs of the High School Musical song ‘All In This Together’ to keep morale up.
Dr Shah-Armon added she had been working with Preston Road Mutual Aid group and the Shree Jalaram Mandir who had helped to provide staff food for lunch and dinner, and she added: “We also put together a room for staff to relax in if they were feeling overwhelmed.
“Gail in particular has been unbelievable here – absolutely committed and dedicated to our staff. She deserves a medal, an OBE!”
The mental health specialists said their team had also been working to support medical staff at Northwick Park with their own mental health, and to prepare for a “new normal”.
Ms Burrell said the “near future” would of course see “PPE as a matter of course”. Dr Shah-Armon added: “And we’ve really learned that we can do things differently. The speed at which the whole NHS has had to adapt is incredible. We’ve worked out ways of getting frontline staff at the bedside as much as possible, trusting them to make decisions and getting rid of bureaucracy. It’s given us a lot of confidence.”
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