Coronavirus: Inside the UK’s only secure mental health COVID-19 ward
Written by News on 22/04/2020
“I’m just fed up man! I want to know what you are keeping me in here for?” shouts a 56-year-old paranoid schizophrenic.
The COVID-19 ward at the Claybrook Centre in Hammersmith is unique because every patient is being detained under the mental health act – so they are not in treatment under their own free will.
Add to that the isolation of a coronavirus ward and it creates a complicated relationship between patient and doctor.
“So, you are otherwise feeling ok?” asks Dr Roopak Khara politely. “But you’re a bit upset about being on this ward which is understandable.”
She wants the nurse to bring in a vitals monitoring machine to test whether the patient is improving or deteriorating, but it’s a negotiation to get it through the door.
After a few minutes of dealing with the patient’s personal needs, they wheel in the machine. The good news is the patient’s symptoms are receding.
Just as this is distressing and confusing for the patient, the medics too are out of their comfort zones.
Mental health specialists are now dealing with a deadly virus. The Claybrook Centre is the first COVID-19 ward in the UK for mental health patients, and it is a huge gear change from what the staff are used to.
Dr Khara says: “I am a general adult psychiatrist, so this is a slightly different sphere of competency for me to be working in. But all of my colleagues on the ward are working on the edges of our normal competencies. We are making sure we’ve got support to do that.”
The unit has been in close liaison with colleagues in A&E, as well as specialists in infectious diseases, to try to bridge the gap between their respective disciplines. They have set up a “red zone” within the ward and a sterile area where they change into personal protective equipment.
The aim is where possible for the mental health unit to ease the burden on other NHS departments by dealing with their own COVID-19 patients. Only if the individual deteriorates are they then passed on to intensive care wards elsewhere.
Francisca Fearon, the ward matron at the Claybrook Centre, says: “One of the first times I had to tell a patient they had COVID-19, the patient turned to me and said: ‘Am I going to die?’.
“It took me by surprise because suddenly I was struck by the reality of what we are dealing with. But we tell them most people recover, and we try to reassure them.”
Dr Khara says: “Our duty of care is always to the patient we just have to be responsive to the changing needs – and these really are changing needs.
“But what’s unique about mental health units is most patients here don’t know why they are in hospital, don’t want to be in hospital and they don’t know why the doctors working with them are wearing Personal Protective Equipment.”
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Staff at the Claybrook say they have enough PPE, but they are constantly moving from the sterile zone to the red zone which involves the process dressing up in masks, goggles and aprons – then taking them off and sterilising afterwards.
Staff Nurse Kathleen Divers says: “We can go in and they might ask for a cup of tea and then we have to go out and do the whole process again.”
As mental health specialists the staff are aware of the personal impact of this changing environment.
“We all have our moments,” says nurse Divers. “We’re still human but we deal with it together. We have psychological support for the staff as well. Morale in the unit is really high.”
Dr Khara adds: “It’s a worrying time for everybody. It is a worrying time for doctors. I come from a very big family of doctors and we are all worried about going to work every day.
“But what I try to keep in mind is that a lot of people are isolated at home and the positive part of this is at least we are in a job where we are able to come to work every day and we can see our colleagues every day and I try to focus on the positive side of it.”
The Claybrook will be the blueprint for other mental health wards in the UK dealing with the virus. It’s clear that the staff here are eager to adapt and are dedicated in their task of helping the most vulnerable in society. Even if that means being shouted at by their patients.
Already they are bracing themselves for the next wave of complications, with increased mental health problems in society caused by the isolation of lockdown.
But for now, they have to cope with new challenges that are testing the mental well-being of the medical staff themselves.
(c) Sky News 2020: Coronavirus: Inside the UK’s only secure mental health COVID-19 ward
