Organisation and Timeline of Measures in French Psychiatric Establishments during the First Wave of the COVID-19 Epidemic: EvOlu’Psy Study

Abstract

Background: The onset of COVID-19 required rapid organisational changes in the mental health domain. Most mental health-care departments appear to have set up infection control measures and also organised planning, coordination and measures that enabled them to provide psychiatric care in a restrictive environment. Our objective was to assess the organisation by psychiatric facilities in France of their response to COVID-19, while considering their timelines and their sectorMethods: An audit with 48 items was proposed to 331 hospitals in metropolitan France with a capacity for full-time, that is, inpatient psychiatric hospitalisation of adults.Results: Of the 331 establishments contacted, 94 (28.4%) agreed to respond to the survey questionnaire. Full-time inpatient hospitalisation was completely or partially maintained by 94.7% of facilities. Specific measures concerning respect for patients' rights included updates of their procedures on the following themes, reported by 58.5% of establishments. Overall, 74.5% had set up a dedicated channel of care for patients at risk of severe COVID-19, and 52.1% a system for routine screening at admission for these risk factors. Nearly half the establishments (48.9%) reported they had set up specific training programmes for patients about barrier measures and social distancing.Conclusions: French psychiatric establishments on the whole were able to provide a necessary reorganisation of their management of patients and their families, regardless of facility status. Patients' rights nonetheless seem to have not received the attention they merited during the early pandemic period. Somatic management of patients with mental illness must absolutely be improved.

Global impact of the COVID-19 pandemic on mental health services: A systematic review

“…conducting assessments & treatments remotely) face-to-face services with PPE with diverse impacts on the patient-MHCP relationship. high Legrand, G., Boisgard, C., Canac, B., Cardinaud, Z., Gorla, M. G., Gregoire, E., … & Vaury, P. ( 2021 ). Organisation and timeline of measures in French psychiatric establishments during the first wave of the COVID-19 epidemic: EvOlu’Psy study.…”

“… Grover et al (2020) administered an online survey to members of the Indian Psychiatric Society and found a total shut down for 6.3% of all MHS during lockdown. Legrand et al (2021) used a structured audit grid and a phone survey of hospitals with inpatient psychiatric units in metropolitan France. The researchers found that while 94.7% of services maintained fulltime inpatient hospitalisation, 96.4% of services closed or only partially maintained day hospitalisation under the first COVID-19 wave.…”

“…The authors identified shifts towards reduced bureaucracy, more flexibility, and agile and responsive ways of working. In many places, helplines and new crisis services were rapidly established as alternatives to emergency departments, and some community MHS changed the type of help offered, such as starting to provide resource packs for patients ( Johnson et al, 2021 ; Legrand et al, 2021 ; Nair et al, 2021 ).…”

“…Home care and visits were maintained by 86.9% of the responding institutions in France ( Legrand et al, 2021 ), but were continued only when absolutely necessary in the UK ( Johnson et al, 2021 ). Honey et al’s (2021) qualitative secondary analysis of data from people living with enduring MH condition showed that home visits were rarely continued during the pandemic in Australia.…”

“…Professionals started using therapy apps ( Johnson et al, 2021 ), social media ( Jurcik et al, 2020 ; Reilly et al, 2020 ), and messengers to reach out to patients ( Honey et al, 2021 ; Shaw et al, 2021 ), or the general public, patients or families or they established helplines ( Jurcik et al, 2020 ; Legrand et al, 2021 ; Nair et al, 2021 ; Ojeahere et al, 2020 ; Reilly et al, 2020 ; Revet et al, 2020 ; Pajević et al, 2020 ).…”