There are significant costs and public health issues indirectly or directly caused by problems in the workplace, which become even more pronounced during uncertain times such as societal crises. In high-risk organizations with significant social responsibility, the pressure is massive. The ability to swiftly adapt and manage crises becomes crucial, fostering unique work environments that prepares for potential improvements that can be learned from after the crises. Previous studies clearly indicate that more research is needed about improvements and practical implications in crisis situations for both managers and staff in inpatient psychiatry. Earlier studies have focused on narrow research areas and quantitative studies, and seldom within inpatient psychiatry. This study aims to compare different organizational levels and professional groups, and to explore improvements and organizational changes that affect psychosocial occupational safety and health (OSH) in inpatient psychiatry during the COVID-19 pandemic. Additionally, it seeks to contribute to future preparedness and practical implications for managing OSH challenges during crises. Qualitative focus group interviews with a purposive sample of 67 employees from institutionalized psychiatric care were conducted, including six interviews with registered nurses (RNs) (n = 24), six with psychiatric aides (n = 25), three with physicians (n = 9), and three with managers (n = 9). The professional groups experienced both improvements and challenges during the COVID-19 pandemic. The participants described improvements, including clear communication, well-defined responsibilities, transparent information channels, improved hygiene routines, and increased staff cohesion and unity. In addition, external societal support has strengthened morale and resilience, alongside increased appreciation for employees' occupations, both internally in the occupational context and externally in society, which has led to increased motivation among employees. However, despite these progressive developments, OSH challenges persist, particularly for managers contending with staff shortages and increased workloads. This study illustrates the critical role of consistent support, verbal recognition, transparent communication, and organizational flexibility in effectively managing psychosocial OSH during the COVID-19 pandemic.