Reply To: Challenges of Care with COVID-19


Reflecting on the COVID-19 question, one simple barrier I found it provided was losing that direct face-to-face contact and creating a relationship with someone behind a mask. I worked inpatient psychiatry when the pandemic began, and it was often an extra hurdle for clients who may already have difficulties with reading facial cues and interpreting body language to then try and do so when all the nurses and health care staff on the ward had to wear PPE. To break the ice and humanize myself with clients that I have to wear a mask around I will introduce myself as normal and then show them my hospital ID which has a picture of myself and crack a joke about how that’s I how I normally look without the mask. Even though it’s a simple gesture, I think it conveys effort, care and connection.

When conducting assessments during the pandemic, I have similar reflections to others above around the need to use virtual methods instead of in-person. And found that this made services more accessible for clients who may be more anxious, or have social phobias, but limited a full assessment for others who may verbally present really well but when seen in person exhibit poor hygiene, bizarre clothing choices, or observable behavioural tendencies. Something as simple as seeing someone looking around the room and attending to internal stimuli silently would be lost in a phone assessment. For that reason pivoting to a virtual appointment over Zoom, actively gaining collateral from family or friends who have been around the client, or doing outreach with the appropriate PPE were needed.

With our population of young adults and youth I do think virtual connection is an asset as a lot of my clients at baseline functioning aren’t comfortable with phone calls – it’s note as commonplace as when we were younger. Texting has been a great tool for engaging with clients who may take time to reply or find it anxiety provoking to anticipate a scheduled call or be surprised with an unannounced call. It also gives them the opportunity to reflect and think on answers prior to providing them. With assessment tools I’ve been trying to go over certain ones in person, explain bits that may be confusing, begin to complete the assessment or questionnaire with the client, and then I will provide a copy of the form to the client to bring home and work on their own. If they have any changes or additions, great! We’ll update what we have on our end, if not, then at the very least they have a copy of what we’ve done.