Working within child and adolescent mental health services (CAMHS) in London during a time of Covid 19

I work within CAMHS NHS London as a Consultant, and lead a large service of child adolescent and family clinical psychologists. There was no time to prepare for anything but emergency measures going into lockdown. We were not allowed to continue clinical meetings, since we could not sit in a room together for more than 15 minutes and we were required to social distance; in an overcrowded work place this is hardly possible. We resorted zoom etc and adjusted very quickly as did our families for the post part.

As NHS key workers we have been expected to continue to provide services, as usual, and continue to see patients who were suicidal or at risk. There was no PPE initially, not even hand sanitiser for the first weeks and it did require courage. Immediate arrangements needed to be made for vulnerable workers who needed to shield ahead of government announcement and this produced some management conflict. The hospital trust attended COBRA meeting each day and organised its services into Gold, Silver, Bronze, and a plan was made for workers to be redeployed to frontline posts, if required, particularly young doctors on psychiatric placements with us. A wellbeing work-stream was set up soon after, addressing the psychological and wellbeing needs for staff.

Interestingly, listening rooms set up were largely not attended and staff felt swamped by the plethora of reading material on how to cope. There was concern about confidentiality and rights to service for staff who were traumatised by Covid 19 related experiences; each of us have our own personal lives and histories and the Covid 19 experience sometimes resonates with our own unresolved traumas, not just those of our patients. Arrangements were made offering reciprocal psychological services for our staff by other hospitals to protect staff dignity and confidentiality. 

There has been a strong sense of commitment and generosity by staff towards others during this time. Most of my peers are working double time, and are very unlikely to be reimbursed for their time or generosity. We are thanked by our managers and by the public in the weekly ‘Clap for the NHS’. Weeks into this complex process staff are generally exhausted. We have been asked to think about what the ‘new normal’ will look like in this second phase of Covid 19 and graded return to work, in a time of continued chaos and uncertainty. There is an expectation that the true psychological impact of this time of Covid 19 will only be apparent months and years after this experience. It’s hard to reflect on this experience whilst being in the middle of it. 

On a more positive personal note, the last weeks have been filled with online ballet classes on days I do not work, listening to lots of wonderful music played by my teenager on our very out of tune piano, going on rambling walks through deserted city with my partner, and working on little art or film projects with my child, in lieu of school. We are planning to make a little film called ‘the people upstairs all practice ballet’, a little satire on the impact of noisy neighbours on the sanity of an NHS worker. On that I could write realms.

By Dr Desiree Saddik,
Consultant Lead Child Adolescent and Family Clinical Psychologist
Associate Fellow of the British Psychological Society