Psychiatrists expressed regret over the recent deaths of patients, tied to the infection of the new coronavirus (COVID-19), at a psychiatric ward of Daenam Hospital in Cheongdo, North Gyeongsang Province.

The deaths showed the grim reality of closed psychiatric wards more vulnerable to an outbreak of an infectious disease than general wards in Korea, they said.

Seven of the 10 deaths of new coronavirus occurred at Daenam Hospital in Cheongdo, North Gyeongsang Province. (Captured from Naver’s Road View)

The nation enhanced requirements for involuntary (forced) admission of patients with mental illness by revising the Act on the Improvement of Mental Health and the Support for Welfare Services for Mental Patients in 2016.

However, involuntary psychiatric admissions are still prevalent due to the lack of institutional support and facilities after the law revision, experts said.

Among the eight deaths caused by COVID-19 infection in Korea as of Tuesday, six were patients who were hospitalized at the Daenam Hospital’s psychiatric ward for the long term. Most of them had underlying diseases, including chronic lung disease, more vulnerable to the deadly virus than healthy people. Some of them reportedly had malnutrition.

Jung Ki-hyun, director of the National Medical Center (NMC), said the first death case, a 65-year-old man, had no weight record for 20 years. Still, CT scans showed that he had a skinny fat layer, hinting that he had poor nutrition.

NMC is the secretariat of the Infectious Disease Central Clinical Committee, composed of physicians and experts treating the confirmed COVID-19 patients across the nation. The committee is investigating the exact cause of the deaths of CORONA-19 patients.

Psychiatrists said although there are mentally ill patients who cannot help but get hospitalized for a long time, the government’s anemic support puts them in a blind spot.

Kwon Jun-soo, a psychiatrist at Seoul National University Hospital, said psychiatric wards tend to have lots of group therapies, which cause close contacts among patients and medical staff. “If a virus comes to a place like a psychiatric ward, a fast spread of the disease is inevitable,” he said.

A psychiatric ward where patients were hospitalized for a long time, such as that of Daenam Hospital in Cheongdo, is likely to have patients with chronic diseases, Kwon went on to say.
Long-term inpatients benefit from the national health insurance coverage, and cheap meals for those patients are usually priced at around 3,000 won ($2.47) per meal, he said. “Will this meal be sufficient to provide nutrition for a patient? They have no way to get proper nutrition,” Kwon said.

He noted that there were many other psychiatric hospitals where patients were admitted for a long time in Korea.

Under the Act on the Improvement of Mental Health, psychiatric institutions should go through a review committee’s decision to make a psychiatric admission longer than six months. Still, it is impossible to discharge some mentally ill patients, he added.

Kwon said that even if a psychiatrist determines the discharge of a patient, the patient would have no place to go. “The government should invest in facilities so that psychiatric patients can receive treatment in local communities. After the law revision, however, the government did nothing,” he said.

Hong Na-rae, a professor at Hallym University Sacred Heart Hospital, and public relations director at the Korean Neuropsychiatric Association (KNA), said schizophrenic patients with poor functions might be unable to live outside. In some cases, hospitalization is the only way to care for such patients, she said.

“It is difficult to see this issue only from the aspect of human rights,” she noted.

To prevent the spread of COVID-19 in psychiatric wards, KNA asked the Ministry of Health and Welfare to order psychiatrists to refrain from visiting a mental hospital for the secondary diagnosis of a patient, initially required for hospitalization eligibility review.

In Daegu and North Gyeongsang Province, the government banned a visit for the secondary diagnosis. The ban will apply to the entire country from Tuesday.

soo331@docdocdoc.co.kr

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