Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada.
Ontario Tech University, Oshawa, ON, Canada.
J Psychiatr Ment Health Nurs. 2022 Apr;29(2):381-385. doi: 10.1111/jpm.12752. Epub 2021 Mar 31.
WHAT IS KNOWN ABOUT THE SUBJECT?: In a survey conducted by the World Health Organization (WHO) in the summer of 2020, 93% of countries worldwide acknowledged negative impacts on their mental health services. Previous research during the H1N1 pandemic in 2009 established an increase of patient aggression in psychiatric facilities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Despite expected worsening of mental health, our hospital observed reductions in aggressive behaviour among inpatients and subsequent use of coercive interventions by staff in the months following Covid-19 pandemic restrictions being implemented. The downward trend in incidents observed during the pandemic has suggested that aggression in mental health hospitals may be more situation-specific and less so a factor of mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: We believe that the reduction in aggressive behaviour observed during the pandemic is related to changes in our organization that occurred in response to concerns about patient well-being; our co-design approach shifted trust, choice and power. Therefore, practices that support these constructs are needed to maintain the outcomes we experienced. Rather than return to normal in the wake of the pandemic, we are strongly encouraged to sustain the changes we made and continue to find better ways to support and work with the individuals who rely on or use our services. ABSTRACT: The global COVID-19 pandemic has dramatically changed the operation of health care such that many services were put on hold as patients were triaged differently, people delayed seeking care, and transition to virtual care was enacted, including in psychiatric facilities. Most of the media dialogue has been negative; however, there have been some silver linings observed. Coinciding with the pandemic has been a reduction in aggressive incidents at our psychiatric hospital, along with the decreased need to use restraints and seclusion to manage behaviour. In this paper, we are taking stock of the changes that have occurred in response to the pandemic in an attempt to share our learnings and offer suggestions so that health care does not necessarily return to "normal".
2020 年夏季，世界卫生组织（WHO）进行了一项调查，全球 93%的国家承认其精神卫生服务受到了负面影响。2009 年 H1N1 大流行期间的先前研究表明，精神科设施中的患者攻击行为有所增加。本文的新增内容：尽管预计精神健康状况会恶化，但在实施新冠疫情限制措施后的几个月里，我们医院观察到住院患者的攻击行为减少，随后工作人员对患者的强制干预减少。大流行期间观察到的事件下降趋势表明，精神卫生医院的攻击行为可能更具体，而不是精神疾病的一个因素。这对实践有何影响：我们认为，大流行期间观察到的攻击行为减少与我们组织的变化有关，这些变化是为了应对患者福祉方面的担忧而发生的；我们的共同设计方法转变了信任、选择和权力。因此，需要支持这些结构的实践来维持我们所经历的结果。我们强烈鼓励在大流行之后不要恢复正常，而是坚持我们所做的改变，并继续寻找更好的方法来支持和与依赖或使用我们服务的个人合作。摘要：全球新冠疫情极大地改变了医疗保健的运作方式，导致许多服务暂停，因为患者的分诊方式不同，人们延迟寻求护理，并且实施了虚拟护理，包括在精神科设施中。媒体对话大多是负面的；然而，也观察到了一些一线希望。与大流行同时发生的是我们精神病院的攻击事件减少，以及减少使用约束和隔离来控制行为的需求。在本文中，我们正在评估大流行期间发生的变化，试图分享我们的经验教训并提出建议，以便医疗保健不一定恢复到“正常”状态。
