Table 1
Exploration areas.
| 1) Motivations for participating in MHST, expectations* |
| 2) Supportive work with patients, their families and other health professionals |
| 3) The disease, risk of viral transmission, end-of-life situations |
| 4) Work with other members of the MHST |
| 5) Work with other health professionals in somatic departments |
| 6) Difficult things, supports, what to retain from this experience* |
[i] MHST: Mental Health Support Team.
* Area added after pilot interviews.
Table 2
Sociodemographic characteristics of participants and length of interviews.
| PARTICIPANT | SEX | AGE (YEARS) | PROFESSION | PROFESSIONAL EXPERIENCE (YEARS) | USUAL DEPARTMENT(S) OF ACTIVITY (TYPE OF CARED POPULATION) | LENGTH OF INTERVIEW (MINUTES) |
|---|---|---|---|---|---|---|
| P1 | F | 32 | Psychologist | 6 | CLP (children and adolescents) MPC (children) | 72 |
| P2 | F | 42 | Psychologist | 15 | CLP (children and adolescents) MPC (adolescents) | 55 |
| P3 | F | 42 | Psychologist | 17 | CSPCA (adults) | 55 |
| P4 | F | 34 | Psychologist | 11 | CLP (adults) | 50 |
| P5 | F | 33 | Psychologist | 9 | CSPCA (adults) | 40 |
| P6 | F | 32 | Psychologist | 9 | CLP (children and adolescents) | 42 |
| P7 | F | 29 | Psychiatrist | 4 | DH (children with ASD) MPC (children) | 45 |
| P8 | F | 34 | Psychiatry resident | 3 | CLP (children and adolescents) MPC (children) | 54 |
| P9 | M | 28 | Psychiatry resident | 3 | DH (children with ASD) MPC (adolescents) | 51 |
| P10 | M | 48 | Psychiatrist | 19 | MPC (children and adolescents) | 57 |
| P11 | F | 40 | Psychiatrist | 11 | DH (children with ASD) MPC (children and adolescents) | 63 |
| P12 | M | 40 | Psychologist | 9 | MPC (children) | 63 |
| P13 | F | 39 | Psychologist | 15 | MPC (adults) | 61 |
| P14 | F | 37 | Psychologist | 13 | CLP (children and adolescents) DH (children with ASD) MPC (children and adolescents) | 66 |
| P15 | F | 39 | Health manager | 12 | CLP (children and adolescents) DH (children with ASD) MPC (children and adolescents) | 74 |
| P16 | M | 42 | Psychiatrist | 12 | CLP (adults) | 60 |
| P17 | F | 43 | Psychologist | 15 | MPC (children and adolescents) | 62 |
| P18 | F | 51 | Psychologist | 4 | MPC (children and adolescents) | 52 |
| P19 | F | 35 | Psychiatrist | 9 | CLP (children and adolescents) MPC (children) | 70 |
| P20 | F | 50 | Psychologist | 15 | CLP (adults) | 62 |
| P21 | F | 38 | Psychologist | 3 | CLA (adults) | 71 |
| P22 | F | 62 | Psychologist | 15 | MPC (adults) | 57 |
[i] ASD: Autism Spectrum Disorder; CLA: Consultation-Liaison in Addictology; CLP: Consultation-Liaison in Psychiatry; CSPCA: Care, Support, and Prevention Center in Addictology; DH: Day Hospital; F: female; M: male; MPC: Medico-Psychological Center.
Table 3
Illustrative quotes (right column) by axes and subthemes of experience (left column).
| THE MHP IN THE EPIDEMIC CRISIS | |
|---|---|
| Meeting the needs | Q1: “I had the motivation to make myself useful because I could see that it was panic on board, that it was complicated in hospitals, the hardest thing for me would have been to do nothing during this period… It was also our place as caregivers to be where it was needed” |
| Q2: “At the very beginning we were waiting for demand, which did not arrive, so we broadened our care offer a little, we regularly went to handovers [with clinical staffs], we systematically called families of patients who arrived in the unit, and we went to see patients who needed it […] We saw how it was [in COVID-19 units], it was like war over there, so we can understand that they didn’t have the reflex to call us” | |
| Q3: speaking of having gone to see hospital’s mortuary service: “We wanted to get concrete information on how things were really going in the context of COVID, because we said to ourselves that families were quite lost, that they were certainly going to ask us questions, and we wanted to be able to answer them and help them with details of death aftermath [of their loved one]” | |
| Confronting oneself to the unknown | Q4: “I had a lot of questions about hospital environment, work of psychologist in hospital, because I had done very little of this before, […] I had a lot of positioning questions about that” |
| Q5: “I wasn’t really afraid of the virus, but more of dealing with a fragile, weakened person, fear of not having the right words, of disturbing, of not succeeding in relieving suffering” | |
| Q6: “The first image of my confrontation with this service, that is we arrive and we have a coffin that comes out in the other direction, we were perhaps on the 3rd or 4th day of work, and there I said to myself okay, that’s what we’re going to do right now, I don’t know if I had anticipated that” | |
| Adapting and being efficient | Q7: about telephone support for the daughter of a deceased patient: “I offered to see her, but it was too complicated, […] we didn’t know how to do it, she was all alone, whereas usually [outside COVID-19 period] we are surrounded [during grief]” |
| Q8: “At the beginning we received a lot of anger and guilt from teams, this wasn’t our main mission but well, we were there so we did it” | |
| Q9: “We tried things, we saw that some worked, others did not, it was a real brainstorming the first week, […] we were launched but the design [of our intervention] really came gradually, not at all upstream” | |
| RETRIEVING FUNDAMENTALS OF SUPPORT THERAPY | |
| Being present and listening | Q10: “Finally I used my clinical sense, what I knew how to do, just listening, being in a presence for patients, […] doing simple things, not complicating oneself” |
| Q11: “Listening it’s already huge, just validating, saying yeah you feel that that’s okay, this is already quite a lot” | |
| Q12: “We tried to put in place as many things as possible, even a little banal, […] knowing if they were able to call their family, if they did eat, if they were thirsty” | |
| Q13: “Sometimes I took their hands, I found them really alone, isolated, the least we could do was to approach them anyway, not to stay more than a meter as it was planned” | |
| Bonding with families | Q14: “We made a lot of links between patients and their families, sometimes we held the phone, informing the family that we had seen the patient, we made this link a lot between the patient and his family” |
| Q15: “We reassured patients who sometimes didn’t understand why their children didn’t come, no this is not that they’ve forgotten you, this is that visits are not possible” | |
| Q16: about calls to the family of a patient: “I transmitted what I observed from Mrs. B., who certainly was unconscious but who seemed rather calm, appeased… I tried to convey something of how she was in the room” | |
| Ensuring care continuity | Q17: about clinical staffs of COVID-19 units: “We were present with them at the morning meeting where we took information on patients, then we saw each other again during the day to give a brief, […] the state of health of patients moved so fast that I needed to see the doctor again to know where the situation was” |
| Q18: about a patient with COVID-19, leaving maternity ward: “We had zero relay once she was released from hospital, so I called her 2–3 times a week to accompany her return to home, time for anxiety to subside, for her to put herself in her maternal role” | |
| Q19: about another support device for bereaved families: “We said to ourselves, that’s a shame that people don’t benefit from this system, which is very complementary to ours, […] so we called them back to get some news and to tell them that this device existed” | |
| MOVING FORWARD WITH OTHER HEALTH PROFESSIONALS | |
| Relying on teamwork | Q20: “It was both the support of the team in its experiences and in its practice, and at the same time at a more personal level, at the level of this benevolence that we had for each other, I find that it was a mixture of the two” |
| Q21: “It was not a completely assembled device that we had to fit into, but it was something that we had to build together, and that’s what we did, and that was rather interesting, […] that everyone puts a little of his own” | |
| Q22: “I had a lot of admiration for colleagues who usually worked in [psychiatric] liaison, whom I found quite comfortable to initiate discussion both with other caregivers and patients… They served a bit as a model, a guide at the start” | |
| Learning to work along with teams of physical health care | Q23: “There were patients who did not feel well and who could not verbalize it, anxious patients or rather sad patients, the team was kind enough because they really anticipated: when they found that a patient was a little more withdrawn or a little sadder, they called us” |
| Q24: “From the moment we went to the staff at 9am, we were part of the team, from then on it was much easier to interact with doctors” | |
| Q25: about exchanges with other caregivers: “We would arrive by saying do you want us to discuss a little, and in the end it lasted a little longer than classic pose, and that’s what often works in the end, informal times, it’s easier than when it’s organized in a meeting” | |
| Supporting the relational and human aspect of care | Q26: “The idea was that there is a place in medicine for psyche, and that it goes well, that we get there well, and my feeling with this experience of the MHST, that’s it was well done, it was well done” |
| Q27: “Being there, I think it created a link, humanization, because caregivers were in death, in care, in terrible things” | |
| Q28: “I think it was also somewhat our role to support these team reflections on how we take charge, how we mentally support families and patients” | |
[i] COVID-19: Coronavirus disease 2019; mhP: mental health professional; MHST: Mental Health Support Team.