Perceptions, emotional reactions and needs of adolescent psychiatric inpatients during the COVID-19 pandemic: A qualitative analysis of in-depth interviews

Abstract

Background: The new coronavirus pandemic (COVID-19) has been accompanied by severe psychological pressure on the entire population. However, little is known about how this pandemic could affect the more vulnerable population with severe mental illness.Aims: To explore adolescent psychiatric inpatients' perceptions, emotional reactions and needs during the first wave of the COVID-19 pandemic.Methods: Individual in-depth interviews were conducted with nine psychiatric inpatients aged 12-17 years. Through open-ended questions, interviewers initiated five themes: (1) knowledge about the coronavirus pandemic, (2) changes in everyday routine, (3) pandemic-related emotions, (4) helpful thoughts and attitudes and (5) practices for helping adolescents deal with the hardships brought about by the pandemic. A thematic analysis was conducted using line-by-line open coding.Results: With regard to their knowledge of the impact of the current pandemic, almost all adolescents focused on information about the nature of coronavirus and also on existing crisis management practices. Almost all patients identified predominantly negative changes due to the quarantine state, including restrictions on both social life and personal freedom as well as excessive contact with family members during home isolation. As far as their emotions was concerned, adolescents did acknowledge anxiety about self-harm and harming their loved ones as well as mood swings within the family nucleus; anxiety was also manifested about the unknown and the management of the pandemic in other countries. Avoidance of thought rumination about the coronavirus and its consequences, positive thinking and looking towards the future were reported as constructive strategies for coping with challenging emotions. Additionally, a sense of belongingness (provided that they are not alone and share a common experience) seems to have been playing a pivotal role in the adolescents coping strategies. Trust in the authorities and the community was another quite noteworthy point that emerged during the interviews. Lastly, our findings indicated adolescents' benefit from receiving balanced health messaging coupled with balanced thinking within both their social and family environment.Conclusions: Enhanced comprehension of possible mediating psychological pathways is needed to help clinicians, researchers and decision-makers to avert the deterioration of mental disorders and overall functioning, as well as additional stress-related disorders.