Management of COVID-19 Response in a Secure Forensic Mental Health Setting: Réponse à la gestion de la COVID-19 dans un établissement sécurisé de santé mentale et de psychiatrie légale.
Can J Psychiatry
; 65(10): 695-700, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-612091
ABSTRACT
OBJECTIVES:
The coronavirus disease 2019 (COVID-19) pandemic presents major challenges to places of detention, including secure forensic hospitals. International guidance presents a range of approaches to assist in decreasing the risk of COVID-19 outbreaks as well as responses to manage outbreaks of infection should they occur.METHODS:
We conducted a literature search on pandemic or outbreak management in forensic mental health settings, including gray literature sources, from 2000 to April 2020. We describe the evolution of a COVID-19 outbreak in our own facility, and the design, and staffing of a forensic isolation unit.RESULTS:
We found a range of useful guidance but no published experience of implementing these approaches. We experienced outbreaks of COVID-19 on two secure forensic units with 13 patients and 10 staff becoming positive. One patient died. The outbreaks lasted for 41 days on each unit from declaration to resolution. We describe the approaches taken to reduction of infection risk, social distancing and changes to the care delivery model.CONCLUSIONS:
Forensic secure settings present major challenges as some proposals for pandemic management such as decarceration or early release are not possible, and facilities may present challenges to achieve sustained social distancing. Assertive testing, cohorting, and isolation units are appropriate responses to these challenges.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Isolation
/
Pneumonia, Viral
/
Psychotic Disorders
/
Forensic Psychiatry
/
Developmental Disabilities
/
Coronavirus Infections
/
Substance-Related Disorders
/
Hospitals, Psychiatric
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
Can J Psychiatry
Year:
2020
Document Type:
Article
Affiliation country:
0706743720935648
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