A Cross-Sectional Survey of Patients and Staff on Inpatient Forensic Psychiatric Units During COVID-19 Outbreak.
Keywords:COVID-19, schizophrenia, inpatient, forensic, isolation, outbreak
Outbreaks of COVID-19 on inpatient forensic units present a unique challenge as early release is not possible and some facilities were not designed to achieve sustained social distancing . The enforcement of droplet and contact (D&C) precautions required during an outbreak creates further confines and restrictions for patients that are typically subject to considerable constraint during their care. From December 2020 to January 2021 43 clinicians and 12 patients on inpatient forensic units under unit-wide D&C precautions during COVID-19 outbreaks completed a cross-sectional survey regarding their experience. Virtual focus groups were also conducted to triangulate the qualitative feedback from clinicians. The survey and focus groups found the themes of enablers, barriers, and desired changes to care provision during an outbreak. Findings are discussed within the broader context of outbreak interventions and the provision of services to those living and working on forensic inpatient units experiencing outbreaks requiring the unit-wide implementation of D&C precautions.
Simpson AIF, Chatterjee S, Darby P, Jones RM, Maheandiran M, Penney SR, Wilkie T. 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. 2020 Oct;65(10):695–700. https://doi.org/10.1177/0706743720935648.
Lemieux AJ, Dumais Michaud AA, Damasse J, Morin-Major JK, Nguyen TN, Lesage A, Crocker AG. Management of COVID-19 for persons with mental illness in secure units: A rapid international review to inform practice in Québec. Victims & Offenders. 2020;15(7–8):1337–1360. https://doi.org/10.1080/155648 86.2020.1827111.
Franke I, Büsselmann M, Streb J, Dudeck M. Perceived institutional restraint is associated with psychological distress in forensic psychiatric inpatients. Front Psychiatry. 2019 June 11;10:410. https://doi.org/10.3389/fpsyt.2019.00410.
Tomlin J. What does social distancing mean for patients in forensic mental health settings? Forensic Sci Int Mind Law. 2020;1:100018. https://doi.org/10.1016/j.fsiml.2020.100018.
Ontario Agency for Health Protection and Promotion (Public Health Ontario). Best practices for managing COVID-19 outbreaks in acute care settings. Toronto, ON: Queen’s Printer for Ontario; 2021.
Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008 Apr;62(1):107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x.
Fusch PI, Ness LR. Are we there yet? Data saturation in qualitative research. The Qualitative Report. 2015;20(9):1408-1416. https://doi.org/10.46743/2160-3715/2015.2281.
Crosswell AD, Lockwood KG. Best practices for stress measurement: How to measure psychological stress in health research. Health Psychology Open. 2020:7(2)1–12. https://doi.org/10.1177/2055102920933072.
Billings, J, Greene T, Kember T, Grey N, El-Leithy S, Lee D, et al. Supporting hospital staff during COVID-19: Early interventions. Occupational Medicine. 2020 July;70(5):327–329. https://dx.doi.org/10.1093%2Foccmed%2Fkqaa098.
Boland X, Dratcu L. COVID-19 and acute inpatient psychiatry: The shape of things to come. Int JPsychiatry Clin Pract. 2020 June;25(2):132–134. https://doi.org/10.1080/13651501.2020.1801755.
Dieset I, Løvhaug L, Selle M, Kolseth A, Smeland OB, Færden A. Lessons learned from a cross-sectional survey among patients and staff in an acute psychiatric unit during an ongoing pandemic outbreak. Psychiatry Res. 2021 Apr;298:113779. https://doi.org/10.1016/j.psychres.2021.113779.
Hao F, Tan W, Jiang L, Zhang L, Zhao X, Zou Y, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behav Immun. 2020 Jul;87:100–106. https://doi.org/10.1016/j.bbi.2020.04.069.
Soh KC, Khanna R, Parsons A, Visa B, Ejareh Dar M. Masks in Melbourne: n inpatient mental health unit’s COVID-19 experience. Australas Psychiatry. 2021 Apr;29(2):240–241. https://doi.org/10.1177/1039856220968394.
Wu D, Jiang C, He C, Li C, Yang L, Yue Y. Stressors of nurses in psychiatric hospitals during the COVID-19 outbreak. Psychiatry Res. 2020 Jun;288:112956. https://doi.org/10.1016/j.psychres.2020.112956.
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