Managing infection control in mental health settings throughout a pandemic

October 23, 2020

In 2020, the world has been faced with an unprecedented challenge: COVID-19. In a world that is now all too familiar with social distancing, lockdowns, and increased levels of hygiene management and control, it’s to be expected that infection prevention and control (IPC) has played a significant role.

Infection prevention and control (IPC) has a long established and vital role in preventing health care acquired infections. However, the majority of the guidance for this relates to acute general hospitals which is often difficult to translate to mental health settings .

Managing and controlling infections in mental health inpatient settings is a challenge as by their very design, mental health units aim to achieve the polar opposite of social isolation. As such, the COVID-19 pandemic has presented such environments with profound challenges.

Facilities within mental health units promote social interaction, group activity and as far as possible, freedom of movement within the environment. In terms of infection control, the characteristics of the mental health environment, in concert with the model of care, pose significant challenges.

Managing a highly infectious virus whilst at the same time preserving the unit’s primary functions, creates a unique set of circumstances. With the rapid spread of COVID-19, these challenges have never been greater and are likely to persist long into the future.

Mental health settings represent a discreet set of challenges for IPC, including environmental, practice and clinical issues. For example, patients with a disordered mental state may be unable to understand or easily accept the infection control measures put in place.

Therefore, these measures need to be carefully balanced with mental health treatment and infection control needs. Mental health situations need careful management with an acknowledgment that there is the risk that the infection could spread if the patient cannot be effectively isolated.

There are strategies that can be implemented to assist with this thus reducing the risk of spread of infection. Mental health colleagues within the Trust have embraced the changes that we have had to implement to prevent the spread of Covid-19.

Personally, I never imagined that I would see mental health staff wearing scrubs and surgical face masks. IPC colleagues and mental health colleagues are working together to continuously improve guidance for mental health services that reflects the challenges, especially in regard to PPE, which we will keep all affected parties updated about.

Written by Louise Forrister, Lead Nurse for Infection Control for Mental Health & Learning Disability Nursing Projects

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