ABSTRACT

The COVID-19 pandemic has resulted in rapid and unprecedented public policy and legislative interventions to reduce the global spread of the virus. The scope of these challenges has been particularly broad and pressing within health care settings. Individuals with severe mental illness hospitalized in psychiatric facilities are at greater risk of infection than the general population due to both the characteristics of the population (e.g., mentally ill individuals may find the physical distancing measures difficult to understand) and the nature of the settings (e.g., communal living, frequent admissions and discharges). Therefore, it is essential that preventative measures are taken to minimize the chance of nosocomial outbreak in long-term psychiatric facilities; yet minimal information specific to forensic contexts is available. This paper reviews the system-wide strategies that have been put in place across a large Canadian forensic facility and offers recommendations on how to respond to a pandemic or other outbreak in a secure psychiatric setting. Taking the response to COVID-19 in the context of a forensic psychiatric setting, we discuss a wide range of essential aspects of pandemic planning and provide examples of innovative practices that should be considered for retention, future research and broader implementation.

摘要

COVID-19 大流行导致了迅速和前所未有的公共政策和立法干预，以减少病毒的全球传播。这些挑战的范围在医疗保健环境中特别广泛和紧迫。由于人群的特征（例如，精神病患者可能难以理解保持身体距离的措施）和环境的性质，在精神病院住院的重度精神病患者比普通人群感染的风险更大（例如，公共生活、频繁入院和出院）。因此，必须采取预防措施，以尽量减少长期精神病院院内暴发的机会；然而，只有极少的特定于法医背景的信息可用。本文回顾了加拿大一家大型法医机构实施的全系统策略，并就如何在安全的精神病学环境中应对大流行病或其他疫情提供建议。在法医精神病学背景下应对 COVID-19，我们讨论了大流行规划的广泛基本方面，并提供了应考虑保留、未来研究和更广泛实施的创新实践示例。