1
|
Simpson AIF, Chatterjee S, Darby P, Jones RM, Maheandiran M, Penney SR, Saccoccio T, Stergiopoulos V, 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; 65:695-700. [PMID: 32573397 PMCID: PMC7312094 DOI: 10.1177/0706743720935648] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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.
Collapse
Affiliation(s)
- Alexander I F Simpson
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Sumeeta Chatterjee
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Padraig Darby
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Roland M Jones
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Margaret Maheandiran
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Stephanie R Penney
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Tania Saccoccio
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Treena Wilkie
- Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada
| |
Collapse
|