| Challenges and uncertainty during the COVID-19 pandemic and beyond |
“It’s absolutely decimated us from the start; we’ve had outbreak after outbreak with our patients...it’s been horrific and continues to be as bad as the onset.” [Social worker; male; UKa 1] “In the early days, we did have to really fight the corner for mental health within...the different services and settings that we have. That, kind of, continued I guess throughout the whole vaccine rollout as well.” [Pharmacist; female; UK 3] “I have seen a lot of people [patients] staying stagnant with us through the COVID period and without the opportunity to go through the rehabilitation phases...I think it had a big impact because people felt like they were stuck there for a very long time.” [Consultant psychiatrist; male; UK 1] “The anatomy of our pandemic...was very different...we initially followed an elimination strategy which was quite successful with the first variants up until Omicron...[we] benefitted from the experience you’d had before.” [Consultant psychiatrist; female; NZb]
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| The need for reliable and trustworthy information |
“It was interesting there were a number of places they [patients and the public] were getting misinformation from.” [Consultant psychiatrist; male; AUSc] “Dealing with many patients who are sceptical of many things such as worldwide pandemics was very challenging.” [Nurse; male; UK 1] “Our wards and our medical teams but also our patients needed to understand what was a really ever-changing picture.” [Pharmacist; female; UK 3] “To be honest, at the very beginning, I think we went back to almost first principles...At the very, very early stages, that’s what it likely came down to, was independent clinical decision making.” [Pharmacist; male; UK 2] “There were definitely areas that we were grappling with, you know, depots, clozapine, benzos, rapid tranq [sic], and also that whole, sort of, vaccine hesitancy and the confusion that came really with different groupings of who went when.” [Pharmacist; female; UK 3] “A lot of the patients we see do have complicated problems with thyroid, renal function complications, combination strategies, etc., and lithium’s always a difficult molecule to manage in that environment.” [Consultant psychiatrist; male; AUS] “A lot of this evidence is around supporting clinicians to make decisions, not about making them for them, so that if you’re going to take a risk, you’re supporting that risk.” [Pharmacist; male; UK 2]
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| Feedback about the current OxPPLd guidance |
“So, I think it’s really fantastic, and I wish, like, we’d probably had sight of some of this before to help with some issues that we’ll have had in all sorts of our cases, that we’ve had to manage during the whole of the pandemic.” [Nurse matron; female; UK 2] “I think that just the dissemination and reach is where it could be improved. I just think it’s only useful if people are actually reading it and using it.” [Mental health care assistant; female; UK 4] “I like the way that it’s laid out by clinical questions and it feels that it’s had a lot of clinical input, that you’ve thought carefully about what is going to matter to patients, families and clinicians. So, the questions are really good.” [Consultant psychiatrist; female; NZ] “Many colleagues that I’ve forwarded it to recently have found it immensely relevant.” [Social worker; male; UK 1] “So I would see it as...evidence-based, this is authoritative.” [Consultant psychiatrist; male; UK 4] “The clinical relevance is the bit that I loved the most. I had questions and I looked and there they were.” [Consultant psychiatrist; female; NZ] “I did notice there were sections that were relevant to specific professions, like there was nursing and...I always appreciate that, to find things that are specific for what we’re doing.” [Nurse; female; NZ] “The first thing that really struck me was the immense number of topics...and the thoroughness with which they’ve been covered...Also, some of the evidence and data that you’ve drawn on to substantiate various claims, again, it was very nice to see that.” [Consultant psychiatrist; male; AUS] “I remember when I wanted to join the clozapine clinic...I got loads of documents to go through, it was so much. I felt the information we have on the [OxPPL] guidelines, is compact, something that one can go through within a few minutes...before you go in for the clinic. So I think it’s much relevant to this present time that we are in.” [Mental health care assistant; male; UK 2] “So, it’s useful in times of great uncertainty where people don’t know what the right thing to do is and they’re worried about what the risks might be to themselves, for example, about clozapine or lithium treatment.” [Consultant psychiatrist; female; NZ] “We’re not in [a] pandemic now, but they’re still useful.” [Psychiatry trainee; female; UK 2]
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| Ideas about future use and relevance to future pandemics |
“It reinforces what you’ve said and they [patients] do remember it better because when they’re reading it later on and it says the same stuff you’ve just read out with them, it makes a lot more impact, or they share it with their partner or someone else...” [Consultant psychiatrist; male; AUS] “I think personally, over the next two to three years...COVID [will] probably remain a topical issue and a pressure in the winter.” [Pharmacist; male; UK 2] “As a model, I think it’s highly relevant to future pandemics or health crises and you could follow that model quite tightly and come out with something excellent much faster than you could the first time.” [Consultant psychiatrist; female; NZ] “So, I think there is a significant role for this kind of guidance going forward...I think if we are susceptible to one pandemic, maybe we might be susceptible to others, as well.” [Consultant psychiatrist; male; UK 1] “So I think that what you’d need to do is have a critical mass of people who could quickly mobilise to generate those questions and check the specific evidence relating to those questions quickly, because there is quite a bit of intensive resourcing that needs to go in, particularly at the beginning, and then keeping something up to date to make it relevant to the front-of-mind questions that people have.” [Consultant psychiatrist; female; NZ]
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