national association of psychiatric intensive care units

Acute Disturbance COVID-19


Much has been learned since the first publication of the NAPICU Managing Acute Disturbance in the Context of COVID‑19 Guidance in March 2020. The last nine months have seen astonishing progress in the understanding of COVID‑19 and the ways in which successful Mental Health Inpatient Services can be maintained. For those of us who have been both delivering and receiving services during this period, the journey continues together towards shared interests and understanding.  The UK became the first country in the world to authorise the use of a COVID‑19 vaccine which is being rolled out across the nation. This will surely reach Mental Health staff and patients sometime soon. That said, there is a long Winter ahead and Services must remain focused, diligent and determined to maintain the approach that has shown success for mental health care while managing potential for infection.

With this in mind, NAPICU is pleased to publish the latest major revision of its COVID‑19 Guidance. Of particular interest may be the sections on physical intervention, PPE and cleansing. The paragraphs detailing this are on the revision list on the first page of the document.

NAPICU is also pleased to report the outcomes of a collaboration to systematically evaluate the performance of PPE used during physical intervention. A brief summary of this project is included in Appendix 2. The full manuscript and data are currently submitted for peer review and publication. In the interim, the learning from the evaluation has been used to inform developments in this Guidance which may be of assistance to Inpatient Services considering this difficult area.

We are hopeful that you will find the NAPICU Guidance helpful. Please do not hesitate to contact NAPICU with any feedback or other suggestions.

NAPICU is proud to have been part of the historic effort to provide quality Mental Health inpatient care and collaboration with patients during this pandemic. We can be legitimately encouraged and enthused by the roll-out of a COVID‑19 vaccine. While we may feel optimistic that a conclusion to this pandemic is on the horizon, we are not there yet.

NAPICU is determined to represent your views and ideas to best effect for improving the experience of patients and staff receiving Inpatient Mental Health Care. To this end, please continue to share experiences and ideas, some of which are represented in the latest version of NAPICU COVID‑19 Guidance.


*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 December 2020)

legal advice note: click here

Practice issues and guidance on delivering and managing occupational therapy and activity-based intervention in PICUs in the context of Covid-19

This document provides some guidance for occupational therapists and the wider MDT based on delivering and managing occupational therapy and activity-based intervention in PICU in the context of Covid-19.  This is a working document informed by occupational therapists’ experiences of good practice, and also communicates current challenges and practice issues which can be discussed/addressed locally.  Such issues will continue to be explored through the NAPICU Occupational Therapy Network meetings or on our webpage (click here)


*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 – (June 2020)


COVID 19 Useful Links

Legal guidance

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

Guidance for Clinicians

Royal College of Nursing COVID-19 guidance

Royal College of Physicians

Royal College of Occupational Therapists

HSJLessons learned from Italian hospitals

Royal College of Psychiatrists

NICE – Rapid guideline: Critical care in adults

Advice for the Public

UK Government – Protecting vulnerable people

NHSAdvice for everyone

UK GovernmentWhat you need to do

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