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COVID-19 and Mental Health Studies Register

COVID-19 is the illness caused by the SARS-CoV-2 virus (coronavirus). For some, COVID-19 is life-threatening and requires critical care i.e. admission to intensive care unit (ICU) or high dependency unit (HDU). People from Black, Asian and Minority Ethnicity (BAME) backgrounds have been disproportionately affected by COVID-19; a report on ICU admissions for COVID-19 in England and Wales showed a higher proportion of patients were BAME compared with a historic cohort admitted for viral pneumonia. The impact of COVID-19 within BAME communities has been highlighted as an important priority for psychological research.

Admission to ICU/HDU is stressful; patients may experience pain, hunger, thirst, confusion and hallucinations, in the context of limited autonomy and ability to communicate. Mental health problems (e.g. post-traumatic stress disorder, anxiety, depression) have been reported frequently in people following admission to ICU/HDU. Acute psychological reactions during admission have been identified as a risk factor for subsequent mental health problems. Rather than exposure to stressors per se causing distress, it is theorised that the meaning ascribed to stressors by individuals determines their acute psychological reaction. Therefore many studies have explored people’s experiences of critical care. Findings have informed the provision of critical care and psychological interventions during and after admission. For example, the importance of close family and friends visiting, and quality of interactions with nursing staff have been highlighted. COVID-19 has dramatically altered the ICU/HDU environment and has introduced further potential stressors for patients (e.g. lack of visitors, staff wearing personal protective equipment).

Some researchers have highlighted that current literature has focused on people’s experience of critical care and neglected to explore the wider issue of the critical illness itself. They propose that the personal meaning and consequences of critical illness to the individual may also contribute to subsequent mental health problems. Furthermore, current literature has not considered the impact of diversity characteristics (e.g. gender, ethnicity, age) on people’s experiences. We each possess an array of intersecting diversity characteristics which influence our interpretation of events. Given the emerging discrepancies in the impact of COVID-19 it is important to acknowledge and explore how critical illness has been experienced by people identified as being at higher risk.

The current study intends to explore survivors’ experiences of critical illness with COVID-19, for people who self-identify as BAME. This study aims to recruit 6-8 adult BAME participants who have survived critical illness with COVID-19 and who were treated in ICU/HDU the UK. Individual interviews will be conducted with each participant. Interview questions will guide exploration of participants’ experiences and the personal meanings that they attribute to them. Analysis aims to be interpretive rather than simply descriptive. The findings may help inform psychological interventions to support this population during recovery from critical illness with COVID-19.

Cutler, L.R., Hayter, M., and Ryan, T. (2013). A critical review and synthesis of qualitative research on patient experiences of critical illness. Intensive and Critical Care Nursing, 29, 147-157.

Intensive Care National Audit and Research Centre (2020). ICNARC report on Covid-19 in critical care. Available at: https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports.. Date accessed: 27/8/20

Smith, J.A., Flowers, P., and Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. London, England: SAGE

Wade, D.M., Howell, D.C., Weinman, J.A., Hardy, R.J., Mythen, M.G., Brewin, C.R., Borja-Boluda, S., Matejowsky, C.F., and Raine, R.A. (2012). Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. Critical Care, 16, R192