NSW public hospital and health services require staff, patients, visitors and contractors to be screened when entering all health facilities. Screening will help identify anyone who may require testing and increase protection for everyone in these facilities.

Detailed information on COVID-19 Screening is available at COVID-19 screening at NSW healthcare facilities,

Rapid Antigen Tests (RAT) is being made available for mental health inpatient settings. Frequent rapid antigen screening can reduce the risk of infections in mental health inpatient settings, especially amongst people who do not show any symptoms. To maximise the benefit, screening individuals on admission and then two to three times per week is recommended.

The benefits of RAT are relative to the amount of disease that is present in a population (prevalence), with greater benefit from settings with high prevalence. Further information about RAT is available in the Framework for the Provision of Rapid Antigen Screening for COVID-19 in Clinical and Non-Clinical Settings

What happens after screening?

Patients who are found to be at high risk of COVID-19 after screening should be tested and isolate prior to entering the general ward population. Similarly, pathways should be developed for managing positive results during surveillance screening of admitted patients and staff.

Mental Health Services should consult their local Infection Control and Pathology Services to develop pathways for these instances.

What happens if a patient declines testing?

Advice from the local public health unit and LHD legal services should be sought for options to manage patients who screen as high risk and decline to be tested and/or require involuntary mental health admission.

Some general considerations include:

• Provide accessible information, support and encouragement
• Consider if a family member or support person may be able to provide additional information and encouragement (may need to use phone or other means if the person is unaccompanied and restrictions prohibit attendance).
• If the patient is agitated and this is impacting on their decision making, consider de-escalation techniques and offer medication. Revisit the testing request when the person is calmer.
• If the patient is unable to provide information/history, obtain corroborative history from family/carers to clarify whether they have visited any venues of concerns (as listed in NSW Health COVID-19 case locations) or have been identified as close contact of someone with COVID-19.
  The person should remain isolated from other patients (managed in designated room in the relevant unit) while continued efforts are made to encourage testing.
• Staff managing this patient must wear full PPE (contact, droplet and airborne - link to IPAC manual Appendix 4A). The patient should be requested to wear a face mask.

See NSW Government - Symptoms and testing for further advice on COVID-19 screening and testing including and additional symptomology ​​.