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New ways of working: COVID-19 as a catalyst for change in acute mental health services

Published online by Cambridge University Press:  19 July 2023

K. Tong ,
G. Crudden ,
W. X. Tang ,
D. McGuiness ,
M. O’Grady  and
A. M. Doherty
K. Tong*
Affiliation:
1National Forensic Mental Health Service, Central Mental Hospital, Dundrum
G. Crudden
Affiliation:
2Department of Psychiatry, School of Medicine & Medical Science, University College Dublin 3Department of Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
W. X. Tang
Affiliation:
4East Sussex NHS Trust, East Sussex, United Kingdom
D. McGuiness
Affiliation:
5Department of Psychiatry, University Hospital Galway, Galway, Ireland
M. O’Grady
Affiliation:
5Department of Psychiatry, University Hospital Galway, Galway, Ireland
A. M. Doherty
Affiliation:
2Department of Psychiatry, School of Medicine & Medical Science, University College Dublin 3Department of Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
*
*Corresponding author.

Abstract

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Introduction

A need arose to divert patients with psychiatric complaints from the emergency department to alternative settings for psychiatric assessments to reduce footfall and to conduct consultations in a timely manner during COVID-19.

Objectives

We assessed the effectiveness of alternative referral pathway in reducing COVID-19 infection in our service, and its effect on service quality: response time and number of patients leaving before review. We evaluated the satisfaction of patients, General Practitioners (GPs) and mental health service (MHS) staff with the pathway.

Methods

All patients referred to the mental health service over a 2-month period following the introduction of the pathway were included. Findings were compared against the cohort referred for emergency assessment during the same period in 2019. Feedback surveys were distributed to patients, staff and GPs. χ ² and independent sample t-test were used to compare the variables.

Results

Over 2 months, 255 patients received an emergency assessment via the pathway, representing a 22.3% decrease in the volume of presentations from the same period in 2019. There were no COVID-19 cases among our patients or staff on the roster for assessing patients. In comparison to 2019, response times were improved (p<0.001), and the numbers of patients who left the hospital before the review were reduced by 3.2% during the study period (p<0.001). Patients and GPs were highly satisfied with the referral pathway and believed that the pathway should be retained post-COVID-19. Mental health service staff were divided in their opinions about its sustainability.

Conclusions

The pathway was successful in reducing the spread of infection, improving response times and reducing the numbers of patients who left without an assessment. Given the improved outcomes and acceptability, this is a preferable pathway for emergency referrals into the future.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S310
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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