Clinical placements

Isolation and COVID-19: what I learned from my placement at a mental health hub

A nursing student saw first-hand the need for early interventions in mental healthcare

A nursing student saw first-hand the need for early interventions in mental healthcare

Picture: iStock

I am a mental health nursing student about to start the final year of a two-year preregistration MSc course.

Though I was in my first year of study, my previous experience as a support worker meant I was eligible to work during the height of the COVID-19 pandemic, and in June I started working at the Hub a centre for mental health services at my local hospital.

Student placement gave me a range of experiences

The flexibility of my student status meant I was able to split my time between a general assessment team, liaison psychiatry and the crisis resolution and home treatment team (CRHTT). This enabled me

A nursing student saw first-hand the need for early interventions in mental healthcare

Picture: iStock

I am a mental health nursing student about to start the final year of a two-year preregistration MSc course.

Though I was in my first year of study, my previous experience as a support worker meant I was eligible to work during the height of the COVID-19 pandemic, and in June I started working at the Hub – a centre for mental health services at my local hospital.

Student placement gave me a range of experiences

The flexibility of my student status meant I was able to split my time between a general assessment team, liaison psychiatry and the crisis resolution and home treatment team (CRHTT). This enabled me to gain a range of experience that may not have been possible during a more conventional placement.

Although I was initially anxious about the risk to my own health posed by the pandemic, I was reassured by the stringent procedures and protocols in place at the hospital to protect staff and patients.

COVID-19 infection control measures became second nature

The hand sanitisers and boxes of masks served as a constant reminder of the risk of the virus, particularly at the start of my placement. But as the weeks went by, wearing a mask every day and following other preventive procedures set out by the trust became second nature.

As none of our patients tested positive for the virus, it felt as though the threat of COVID-19 was receding, and it was easy to become desensitised to the risk. I managed to create a sense of normality within the climate of chaos and fear, perhaps to protect my own mental health.

As the CRHTT was the busiest team, I worked mostly with them. Part of my role was searching for beds after an assessment indicated that an individual required inpatient admission.

Finding a bed can be challenging enough under normal circumstances due to high demand, but after the pandemic began those requiring admission also had to have a swab for COVID-19, followed by a period of isolation while waiting for their results. Alternatively, the patient would need access to a seclusion area where they could be quarantined.

Pandemic precautions disrupted the admission process

During my placement I met a new mother, I will call her Grace, who had been referred to the CRHTT. We attended a home visit in the afternoon and it became clear by the end of our meeting that she would require an urgent referral, ideally to a mother and baby unit.

Grace couldn’t be swabbed at home as we weren’t able to guarantee that she could stay isolated. Although the mother and baby unit had a bed available, they were unable to quarantine Grace due to a lack of staffing.

But we later received a phone call from the unit saying that after moving staff around, they would be able to take her. I was informed next morning at handover that both Grace and her baby had been admitted and were safe.

Although the situation with Grace ended well, the protective measures put in place due to COVID-19 felt like a barrier to addressing her mental health needs.

Lockdown interfered with people’s coping mechanisms for depression and anxiety

In my last week with the CRHTT, a man in his thirties was referred to us. He presented as high risk, with suicidal ideation and a clear plan of how and when he wanted to end his life.

We identified in our first conversation with him that the isolation of lockdown had been the catalyst for the quick decline in his mental health. While he had experienced some symptoms of depression and anxiety in the past, he had been able to manage these feelings successfully himself.

‘Hundreds of people who tried to access mental health support during lockdown were unable to get the help they needed, increasing vulnerability in those who were already vulnerable’

But his mental health had started to decline when many of his coping mechanisms and social opportunities were taken away due to lockdown, and he recognised that he was no longer able to cope. Fortunately, he was keen to engage with our services and we were able to identify support strategies he could use in the community.

This service user was one of many I worked with who identified the isolation associated with lockdown as a damaging trigger for their mental health issues.

This is reflected in a survey of more than 1,400 people with mental illness, carried out during April and May by the charity Rethink Mental Illness, which found that the implications of lockdown, such as sudden changes to routines and not being able to see loved ones, contributed to a deterioration in people’s mental health.

More than three quarters of those surveyed said their mental health had got worse or much worse as a result of the pandemic and the measures put in place to contain it.

We need to be prepared to deal with the lasting impact of COVID-19

The number of people accessing our services increased significantly throughout my placement and I’m sure this happened across the UK. Yet a survey of more than 8,000 people from mental health charity Mind found that hundreds of people who tried to access mental health support during lockdown were unable to get the help they needed, increasing vulnerability in those who were already vulnerable.

The COVID-19 pandemic has also taken its toll on nurses’ mental health, with nurses and nursing students at risk of depression, post-traumatic stress disorder and even suicidal thoughts.

If we are to help people cope with the effects of COVID-19 on their mental health, now and in the future, greater investment in mental health services is urgently needed.

As well as improving current systems and service provision, identifying and addressing an individual’s declining mental health early on would help ensure they can access the support they need and improve the overall well-being of the population.


Eleanor Sivier is a mental health nursing student at the University of Plymouth

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