Acute Disturbance Covid-19


Introducing COVID-19 and acute disturbance

What a difference a week makes!
The NHS and health services around the world are engaged in a global effort to defeat COVID-19. As always, it is the most vulnerable amongst us who are at particular risk from this novel coronavirus.  Those most vulnerable include our patients, some of whom may also present the additional challenge of being unable or unwilling to follow our lead on how best to stay safe themselves and to protect others.  We have all seen the pictures from Lombardy, Italy. Nurses, doctors, cleaners, porters and countless  others selflessly bringing their skills to alleviate suffering and saving lives. Also, we have been humbled by many thousands of retired NHS colleagues who have also volunteered, and now the request for a further 250 000 civilian volunteers, mobilising to join the UK fight.

We can, and we must join this global effort with our NHS colleagues to maintain the health and
safety of those with acute mental health problems.  Given the speed of recent developments, many of us have not had the time for the level of planning that this situation deserves. That said, compassion, creativity, commitment and determination are available to us in any measure we choose to take them. Members of NAPICU, including front line practitioners and service users, have developed COVID-19 and acute disturbance guidance with the aim of assisting in possibly the mental health system’s most difficult of ethical choices.

This challenging time will pass and there will be time to reflect. It is what we do now to support our patients, our service and each other that will define how history judges us. Or more importantly, how we may in the future judge ourselves. I am confident that we can overcome any challenge that tests us over the coming weeks.  As the situation develops, these guidelines will be continually revised and may substantially change as we learn more and adapt to the successes that we will achieve in providing services over the coming weeks. NAPICU hopes that these guidelines will help practitioners, service managers and others maintain quality services until these current difficulties are resolved.

I look forward to seeing you on the ward.

Roland Dix
RMN and Consultant Nurse, Approved Clinician


*NB: This guidance will change as developments in the pandemic occur therefore only this link will give you the most up to date version of the guidance – (Revised 1000 BST 31 March 2020 [3.12 added])

legal advice note: click here



COVID 19 Useful Links

NHS Legal Guidance: Mental Health (Learning Disabilities & Autism)

HSJ COVID 19 information  (RCPSYCH guidance for clinician) (NICE COVID-19 rapid guideline: critical care in adult