Limiting transmission of COVID-19 in an inpatient psychiatric hospital using a special care unit as a behavioral health model - Michigan, March 1-August 31, 2020

Abstract

Approximately 53,000 patients/year are admitted to psychiatric hospitals in Michigan and treatment typically involves social gatherings and group therapies (SAMHSA 2017; Michigan DHS 2019). Often psychiatric inpatients are in close proximity placing them at high risk of infection and have comorbid medical conditions that predispose them to severe COVID-19 consequences. In March 2020, Pine Rest Christian Mental Health Services, Grand Rapids, MI initiated protocols and precautions to mitigate the spread of COVID-19 between patients and health care personnel (HCP) based on emerging CDC guidelines. Multiple strategies [COVID-19 testing, masking of patients and HCP, restricting visitors, and creation of Special Care Unit (SCU) with negative pressure] were effectively implemented and limited transmission of COVID-19 within Pine Rest. Admission to the SCU totaled 25 adults (three Pine Rest patients who tested positive during or after admission, and 22 COVID-19 positive patients who were transferred from other facilities). Average age of SCU inpatients was 38.5 ± 16.6 years with the majority being male. Average hospitalization was 9 ± 4 days. Among the 21 COVID-19 positive HCP, 15 [71%] provided direct clinical care on various units, zero provided care on the SCU, and six had roles with no direct patient care. Average age among COVID-19 positive HCP providing direct patient care[n = 15] was 29.5 ± 13.5 years, majority were female, and 3 [20%] were admitted to local medical hospital for treatment. This report demonstrates that quality behavioral health care can be safely provided at inpatient psychiatric facilities and serve as a guideline that other psychiatric facilities can follow to decrease transmission in future epidemics.