Perspectives on the COVID-19 Pandemic Response in a Forensic Psychiatric Hospital: Informing Future Planning

Abstract

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.