CONSULTATION-LIAISON PSYCHIATRY RESPONSE TO THE IMPACT OF BUSHFIRES, VOLCANOS AND COVID-19 ON A STATE-WIDE BURN CENTRE

ABSTRACT

Background: The Statewide Burns Unit (SWBU) at Royal North Shore Hospital, one of two burns units in NSW, is a 12-bed unit run under the plastics/burns surgical team, nurse unit manager and multidisciplinary allied health team. Consultation-liaison (CL) psychiatry provides a part-time CL psychiatry registrar supervised by a parttime CL psychiatrist, who see and assess all admissions for pre-morbid and/or new and emerging acute mental health (MH) issues. Over 2019-2021 the SWBU saw significant numbers of burn injury patients because of several natural disasters and a spike in self-immolation during Sydney's COVID-19 lockdowns. The traumatic nature of the injuries was challenging for staff to manage over such a prolonged period. Senior team members were aware of the urgent need to (1) increase support for staff to minimise burnout risk and (2) improve access to longer-term psychological treatments for patients after discharge. Objectives: To report on the MH issues managed during this time, the management challenges and the process of significant service development, aiming to address unmet patient need as well as staffing, burnout and vicarious trauma. Methods: Naturalistic file review and NSW Statewide Burns registrar review supplemented by data from interviews with SWBU multidisciplinary team staff members. Conclusion: Trauma-informed and relational care is at the heart of the SWBU multidisciplinary team approach to care, requiring high-level service support and funding. CL psychiatry services can have a significant role in promoting service development, which sits under CanMEDS hats of clinical expert, advocate and leader.