Table 4.

Frequently cited examples of the groups of service users about whom staff participants have been especially concerned during the pandemic: qualitative content analysis of open-ended responses (See Table 11x in the Supplementary report for further details)

People with conditions resulting in specific concerns

People who are cognitively impaired (e.g., due to dementia or learning disability), who may find situation hard to understand and struggle to follow guidance People with psychotic symptoms that may be exacerbated by current events and interfere with their ability to follow guidance People with complex emotional needs (who may have a “personality disorder” diagnosis), who may be destabilised by abrupt loss of support and routines; People with anxiety or OCD, especially those for whom COVID-19 interacts with contamination-related symptoms Women with perinatal mental health problems, lacking usual support and assessment around the time of birth People with drug and alcohol problems, for whom treatment and support are often severely disrupted and following guidance may be difficult People with eating disorders, at risk from disruption to usual eating, exercise, and social routines and to food access

People of concern due to impacts related to social circumstances or characteristics

People who live alone/are currently socially isolated and lonely Older people with mental health problems, due to loss of usual support (e.g., family visits) and additional physical health vulnerability People who are in households where there is domestic violence or conflict Children in homes that may not be safe or where there is family conflict People living in poverty/poor housing, or who are homeless, for whom the lockdown is especially difficulty

People of particular concern due to service disruptions

Inpatients who have experienced service disruptions, including precipitate discharge, delayed discharge because of infection concerns, lack of leave or visits, and increased isolation and lack of activity or therapies on the wards People who are difficult to reach in the community without usual visiting/outreach/face-to-face appointments and may not be seeking help that is needed People at risk because of disrupted availability of medical responses, e.g., for people who harm themselves and are discouraged from visiting/reluctant to visit emergency departments