Mental Health and Quality & Safety of Care in Czech Residential Institutions during the COVID-19 Pandemic: A Mixed-Methods Study.

Long-stay institutions have been considerably affected by the COVID-19 pandemic. We aimed to assess the mental health of clients and staff as well as quality and safety of care in long-stay institutions during the state-of-emergency in the Czech Republic in response to COVID-19 pandemic. We found a high prevalence of poor mental health outcomes in clients (46% poor well-being, 58% depression, 45% anxiety) and staff (17% poor well-being, 22% depression, 14% anxiety). In clients, COVID-19 health-related and economic worries were associated with depression (1.79, 95% CI = 1.14; 2.8 and 2.28, 95% CI = 1.27; 4.08 respectively) and anxiety (1.63, 95% CI = 1.11; 2.4 and 1.85, 95% CI = 1.2; 2.85 respectively) and in staff with any mental health outcome (1.92, 95% CI = 1.33; 2.77 and 1.75, 95% CI = 1.15; 2.66 respectively). Lack of information and communication from authorities, lack of protective equipment and logistic difficulties were reported as challenges. Delivery of care was mostly disrupted as well as admission and discharge processes. Other reported issues included lack of staff, lack of activities for patients or an increase in usage of restrictive measures. Best practices and key future measures were identified by each institution, a summary of which is presented in the article.