Mental health care in the community: England

Submitted by ICN
May 20, 2020

I am a community psychiatric nurse (CPN) who works with people with long term mental health problems in Yorkshire, England.

Normally I usually have face to face contact with the people on my caseload, but the COVID-19 pandemic means I am unable to meet with my clients.

I see some of the people on my caseload every week, some alternate weeks and some less often. Whenever they are in a crisis I see them more often.

I am fortunate that I know the majority of the people I work with well and that they understand how the usual ways of working are currently not possible.

The vast majority of the people I see are supportive of this and are able to accept that the majority of our contacts are currently over the phone or by video.

I do travel to people’s homes to administer their long-acting injectable medication, and I see one other female patient who has complex needs in the building where I work: all other contacts are by phone.

I work 30 hours a week over three days, an arrangement that helps with my own stressors and improves my work/life balance.

During the pandemic, my husband continues to work part-time as a postman. I go into my work base on the one day a week when I am on call with one other member of staff: the rest of the time I work from home, where I have my own office.

I find it hard and frustrating that I do not have face to face contact with my clients. I find it difficult to assess what is happening over the phone with some people – I find it hard to reassure people and encourage them to express their emotions more if I’m not able to see them. I also understand that this is part of my own anxiety.

I am a great believer in giving people time and allowing them to discuss whatever they want, and over the phone, this seems a bit more difficult.

I do have one female client who seems to talk to me more on the phone than she does when I visit, which is interesting and, on reflection, understandable.

I miss seeing some colleagues and feel it is harder to get some support, although my line manager has been great and is accessible on the phone or email, and will meet up if necessary. I have supervision with a psychologist, and we still do this on skype, so that’s really helpful.

We have a daily FACT (Flexible Assertive Community Treatment) meeting, which does allow for some discussion, but the more casual support that is normally available when everyone is working in the same building is missing.

Since these new arrangements have been in place I have become more ‘tech savvy’, which is a good thing.

I have adjusted to working from home and have good self-discipline. I get up and dressed and start work at my normal time and finish at my usual time or later. I do not have proper lunch break, but if I have five minutes to check on how my daughter is or to hang out the washing, I do.

I get frustrated when others assume that people who work from home don’t work as hard those who work in an office – I know some people don’t, but others really do. However, this situation has highlighted that some colleagues are not committed to their jobs and are taking advantage of not being closely supervised.

I had hoped that, as I was not seeing people face to face, all my paperwork would be up to date: that has not happened. I am spending a lot of time on the phone and I continue to believe that client contact remains my number one priority.

Contributor: Carol Davenport