A psychiatric inpatient unit for people with COVID-19 at the University of Rochester Medical Center aims to treat patients while preventing an outbreak.
Psychiatrist and family doctor Kevin Brazill oversees the unit. Every person who is admitted for care is swabbed for the coronavirus, he said; if they test positive and are asymptomatic, they are sent to this unit.
“Basically what we’re trying to do is prevent anyone who may be COVID-positive from inadvertently spreading the virus to other people,” Brazill said.
That's important because unlike other hospital stays, in psychiatric hospitalization, patients interact with each other and staff. The communal aspect is part of the therapy, and in an environment like that, the coronavirus could easily spread.
Plans for the specialized unit began after reports of an outbreak in South Korea, before the pandemic had reached Monroe County.
“There was a psychiatric hospital in South Korea where 101 of their 103 patients contracted the virus, and seven of them died,” said Dr. Telva Olivares, URMC’s director of medicine in Psychiatry Services.
Olivares is on the COVID Command Center and was part of a task force to develop a “surge plan” in case of a local outbreak. That plan included the creation of this unit.
“At any given time, we expected that there would be COVID-positive patients with psychiatric, acute psychiatric needs,” she said.
Since May, when the unit first opened, seven people have been treated. Treatment has lasted up to 15 days, but on average, patients are hospitalized for about five days.
It’s a long way from the era of institutionalization. Olivares said that inpatient care is no longer what it was decades ago when there were large psychiatric centers and state mental hospitals.
“There would be 3,000 to 5,000 patients or residents who would be admitted there and stay there for the rest of their lives,” said Olivares.
Instead, psychiatric care has largely transitioned to community-based care, which is what patients often receive after their hospitalization. Brazill said that before someone can be released, they need to have an “ironclad” outpatient treatment plan in place.
And if a patient starts to present worsening COVID-19 symptoms, there is a liaison team of medical staff ready to care for them. Having familiar faces throughout the process can help patients feel safe and improve the quality of their care, he said.
“There’s a lot of fear among people who have had severe mental illness of the medical system because many times they've not had the most positive experiences,” said Brazill.