Psychological distress among hospital caregivers during and after the first wave of COVID-19: Individual factors involved in the severity of symptoms expression.

Coronavirus disease 2019 has spread rapidly over the globe and has put an unprecedent psychological pressure on health care workers (HCWs). The present study aimed at quantifying the psychological consequences of the COVID-19 pandemic on HCWs during and after the first wave and identify sociodemographic, situational, and psychological risk/protective factors for symptoms severity. An online survey was sent by e-mail to all nurses and physicians employed by a teaching hospital in Brussels, Belgium. 542 (20,62%) completed the survey. 47%, 55%, 32% and 52% of participants reported posttraumatic stress, anxiety, depression and insomnia symptoms, respectively, during the peak. Two to three months later, posttraumatic symptoms emerged de novo in 54% of HCWs. It persisted in 89% of those presenting severe symptoms initially. Neuroticism was the strongest predictor of posttraumatic stress, anxiety, and insomnia. Work overload was the strongest predictor of depression and second predictor of posttraumatic stress, anxiety, and insomnia. Other significant predictors included being a nurse, the number of past traumatic experiences, avoidant coping style, and expressive suppression of emotions.

Providing psychiatric healthcare to asylum seekers: reflections and challenges.

BACKGROUND: According to the United Nations High Commissioner for Refugees the number of people forced to leave their home as a result of conflict, persecution, violence or human rights violations remains high with 68.5 million forcibly displaced people worldwide. Asylum seekers are vulnerable in terms of mental health but they receive very little specific psychiatric care. The purpose of this literature review is to examine current situation regarding asylum seekers' psychiatric healthcare. SUBJECTS AND METHODS: This research was conducted using a keyword search on Medline, PubMed and Google Scholar. RESULTS: The literature on the management of the mental health of asylum seekers focuses on the issue of post-traumatic stress disorder. There is little data on other forms of mental illness in this population. The prevalence of post-traumatic stress disorder among asylum seekers is higher than in the general population and its clinical expression is varied and often complex because it involves various vulnerability factors. Guidelines for post-traumatic stress disorder recommend cognitive behavioral therapy with, in some cases, the use of pharmacotherapy. Given the specificities of the asylum seekers' population, in many cases it is not possible to set up such therapy immediately. Asylum seekers face a number of challenges in accessing mental healthcare. CONCLUSION: Management of the mental health of asylum seekers requires special attention and guidelines for the general population are not directly applicable to this specific population. The literature focuses on the issue of post-traumatic stress disorder. This review was not able to analyse the state of existing care offer in Belgium for managing the mental health of asylum seekers and the care pathways they take.

Mobility in Psychiatry, an Alternative to Forced Hospitalization?

BACKGROUND: The number of forced hospitalizations has increased across Europe. One way to reduce these is to set up mobile crisis teams. A reform of psychiatry in Belgium allowed the creation of these mobile teams. These offer an alternative to forced hospitalization. SUBJECTS AND METHODS: 196 situations were referred to the mobile crisis team located east of Brussels in 2017. We examined the orientation of these requests according to the applicants and the reasons for them. RESULTS: It appears that the health sector has the best indications for using the mobile crisis team. CONCLUSION: Access to psychiatric care is of major importance in Western societies. The creation of mobile teams increases this accessibility and should reduce the need for forced hospitalizations. These observations must be confirmed.

Alternative work and world. Chronicity of emergencies and the work in crisis unit.

We describe the legal framework within which we carry out consultations, otherwise called expertises, with view to considering involuntary admissions to hospital for the treatment of mental illness (here called confinements). We note that in our area only 40% of consultations lead to involuntary admissions to hospital, and we believe that this number is related to our consideration of alternative methods of care in the community. We suggest a multi-centric study to evaluate what specific skills are required to properly carry out these assessments and to establish the extent to which the increased workload of assessments is influencing the rate of involuntary admissions.