Table 6 Subjective experience of catatonia and theoretical potential interventions for future research

Fear and anxiety

Nursing in a quiet environment with low levels of potentially stressful stimuli

Allocating regular staff to nurse the patient to allow for familiarity and recognition to develop relatively quickly

Taking a reassuring, non-demanding approach to interacting with the patient during the catatonic state

Emphasizing reassurance about safety of the environment and the caring aspect of the members of the multidisciplinary team involved in the patient’s management

Open, non-threatening and reassuring demeanour at all times to help in reassuring patients

Open sharing of all information regarding intervention plans for care using basic, easy to follow language to ensure there is no confusion. This should be done irrespective of whether the patient is communicative or not

Yearning for family

Psychoeducation sessions with family

Short contact sessions for reassurance re ongoing family support. Increase contact with family and loved ones when aggressive outbursts decrease if patient displays any and explain this link to the patient as well i.e., it is for their safety and the safety of others

Family mediated exercise interventions and support with activities of daily living (supported by a psychotherapist and occupational therapist)

Confusion about orientation and reasons for admission

Providing well-timed, simplified and regular feedback on the management plan (e.g., “Today is Tuesday. The doctor will review your treatment with you today”, or “Today is Tuesday. Mary, the occupational therapist will be seeing you today”, “Sipho, you seem to be having a better day this Tuesday”, etc

Using simple, non-jargon language when talking to the patient and taking opportunities to re-enforce orientation and reasons for admission whenever they present themselves (as in the simple examples provided above)

Reasons for admission and the plan for the day should be conveyed at every patient contact to help lend a degree of predictability to the patient’s immediate environment