Tackling the unseen virus at the unseen frontier

There has been widespread coverage, attention and discussion regarding the anxieties of COVID-19 pandemic in health and social care settings; however, compared to other healthcare environments, mental health care settings have not received a similar level of attention and concern. Interestingly there are unique challenges in mental health units and at the height of the pandemic there has been a significant impact on staff, patients and carers. Mental health staff have had to adapt their ways of working, focusing more on the physical health of patients and caring for COVID positive patients in a mental health unit. Anxiety about the infection spreading to other patients and to staff who interact very closely with patients were significant concerns, with the additional difficulties of accessing the appropriate PPE during the early stages of the outbreak. Some challenges are unique to mental health settings and become even more intense within a psychiatric intensive care unit (PICU). These include difficulties with isolation, social distancing and the reluctance of patients to wear masks. The lessons learnt caring for the most challenging patients in a PICU are explored. The adaptability, flexibility and commitment to providing kind, compassionate care at the height of the COVID pandemic is remarkable.