Social distancing in a psychiatric facility is easier said than done. So far 34 people at Western State Hospital have tested positive for coronavirus.
It's not unusual to hear patients screaming and crying at Western State Hospital, workers say. But lately, they say it's been worse than normal at the massive psychiatric facility just south of Tacoma, Washington.
"This is a massive problem that is going to have continuing ramifications both psychologically and physically," said Lauren Smith, a forensic psychologist at Western State."We have people who are sick, and we have people who are absolutely scared." Most important, in mental hospitals, isolation can be dangerous, far more than in college dorms or other institutions where people live in groups. Social interaction is not a luxury; it is a therapy and it helps save lives. Patients walk the grounds, eat, exercise and go to therapy together.
Inside the outbreakThe first Western State patient tested positive for COVID-19 on March 16, after several feverish days in and out of the hospital. By April 1, according to hospital records, six patients and 14 staffers had tested positive. During March, the hospital conducted a total of 61 tests — all of symptomatic patients. The hospital's 2,600 staffers were told to go through their health care providers for testing.
Murphy said the hospital lacks the resources to test the rest of the more than 3,300 patients and workers, about 280 of whom are now working remotely."It has been difficult really carving the path for how you handle an outbreak like this," said Murphy, noting they were the first major psychiatric hospital to face COVID-19."In looking back, there were definitely some lessons learned … You can never set something up fast enough, especially for a disease that moves so quickly.
Even expanded testing has become fraught. Of the hundreds of tests administered by Western State in April, only 38 were for patients. When the Health Department told the hospital to increase testing, it did not recommend testing asymptomatic patients on wards with known infections among staff. 'They rely on us completely'Both hospital management and workers expressed concern that precautions due to COVID-19 may disrupt treatment of mental illness.
Nonessential and high-risk staff — including some social workers, psychologists and doctors — now work from home. Social worker Maria Claudio keeps thinking about the way patients asked her,"Are you coming back?" She says one patient began punching the doors, kicking and fighting with the staff, screaming"nobody cares," and"I want out."
'We're having to scramble'Facilities nationwide now face the same dilemma as Western State: the balance between physical and mental health.
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