Purpose

Self-harm, including death from suicide, remains a significant public health challenge. The prison population is known to be a high-risk group for self-harm and suicide. The purpose of this study is to explore the trends in the frequency of self-harm over the course of the COVID-19 pandemic within a high-secure hospital. The authors hypothesised that the pandemic could adversely affect the mental health of patients, which could increase the rates of self-harm. Reasons for changes in the frequency of self-harm and the strategies used in response to the pandemic were also investigated.

Design/methodology/approach

This paper encompasses findings from a quality improvement project that investigated self-harming behaviours from February 2020 to February 2021 in a high-secure psychiatric hospital. Incidents of self-harm were recorded based on the hospital’s ward structure. Data was collected on the incidence of self-harm rates over the COVID-19 pandemic, with a focus on how the pandemic may have had an effect on self-harm.

Findings

This paper found an increase in the incidents of self-harm during the initial stages of the pandemic. The first national lockdown period yielded a rise in self-harm incidents from pre-COVID levels. The frequency of self-harm reduced following the first lockdown and returned to pre-COVID levels. The authors explored the psychological effects of COVID, isolation, interpersonal dynamics and changes in the delivery of care as reasons for these trends.

Practical implications

This study demonstrates the substantial challenges of the COVID-19 pandemic to secure psychiatric services. Having an awareness of how the pandemic can impact on self-harm is important, as it allows the correct balance of restriction of our patients’ liberty to a degree deemed necessary to control the pandemic and the delivery of effective patient care. The key clinical implications include the importance of direct face-to-face patient contact, effective communication, therapeutic interventions and activities, the psychological impact of quarantine and the influence the pandemic can have on an individual’s function of self-harm.

Originality/value

This paper is the first, to the authors’ knowledge, to explore the impact of COVID-19 in a high-security psychiatric hospital. The authors also explore possible explanations for the changes in the trends of self-harm and include the consideration of strategies for improving the prevention and management of self-harm in high-secure settings during a pandemic.

中文翻译：

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COVID-19 对高安全精神病院自残的影响

目的

自残，包括自杀死亡，仍然是一项重大的公共卫生挑战。众所周知，监狱人口是自残和自杀的高风险群体。本研究的目的是探讨在 COVID-19 大流行过程中一家高度安全的医院内自残频率的趋势。作者假设大流行可能会对患者的心理健康产生不利影响，这可能会增加自残率。还调查了自我伤害频率变化的原因以及应对大流行的策略。

设计/方法/方法

本文包含一个质量改进项目的结果，该项目调查了 2020 年 2 月至 2021 年 2 月在一家高度安全的精神病院的自我伤害行为。根据医院的病房结构记录自残事件。收集了有关 COVID-19 大流行期间自残率发生率的数据，重点是大流行可能如何对自残产生影响。

发现

这篇论文发现，在大流行初期，自残事件有所增加。第一个全国封锁期导致自残事件从 COVID 之前的水平上升。第一次锁定后，自我伤害的频率降低并恢复到 COVID 之前的水平。作者探讨了 COVID、隔离、人际交往和护理服务变化的心理影响，这些都是这些趋势的原因。

实际影响

这项研究证明了 COVID-19 大流行对确保精神病服务的重大挑战。了解大流行如何影响自残很重要，因为它可以在控制大流行和提供有效的患者护理所需的程度之间正确平衡限制我们患者的自由。关键的临床意义包括直接面对面的患者接触、有效沟通、治疗干预和活动的重要性、隔离的心理影响以及大流行对个人自残功能的影响。

原创性/价值

据作者所知，这篇论文是第一篇探讨 COVID-19 对高度安全精神病院的影响的论文。作者还探讨了自我伤害趋势变化的可能解释，包括考虑在大流行期间在高度安全的环境中改进自我伤害预防和管理的策略。