Forensic psychiatry and Covid-19: accelerating transformation in forensic psychiatry

Abstract

Swift medically led scientifically informed responses to the Covid-19 epidemic nationally have been demonstrably superior to other, non-scientific approaches. In forensic psychiatry and across all psychiatric services, urgent and clinically led responses have underlined redundancies and confusions in the governance of mental health services and a vacuum in policy makers. For the future, a greater emphasis on services for patients with schizophrenia and other severe, enduring mental disorders must aim at reducing standardised mortality ratios, managing risk of violence and improving hard outcomes such as symptomatic remission, functional recovery and forensic recovery of autonomy. This will require more use of information technology at service level and at national level where Scandinavian-style population based data linkage research must now become legally sanctioned and necessary. A national research and development centre for medical excellence in forensic psychiatry is urgently required and is complimentary to and different from quality management.

Polish Experiences of Safety Measures Involving Forensic Psychiatric Inpatients Implemented During the SARS-CoV-2 Pandemic

“…The suspension of visits and passes, isolation of patients in the transitional units, the quarantine of shipments and restriction of group activities is a consequence of a state defined in Polish law as one of “greater need” which assumes it may be necessary to sacrifice one “good” protected by law for the sake of another, on the condition that the “good” which is in this way protected does have unarguably greater value. The need to continue functioning under pandemic conditions may force positive changes in the system of forensic psychiatry, as postulated by Kennedy et al ( 7 ). The introduction of ICT solutions, such as telepresence in courts, can significantly simplify certain procedures and reduce the operating costs of the forensic care system.…”

“…Kennedy et al have noted that the Covid-19 pandemic has accelerated the introduction of tele-medicine technical solutions as telepresence in courts, and changed the hospital daily routine involving, among others, the introduction of disinfection, physical distancing, screening staff, ending visitor access and leave for patients, organizing isolation wards, quarantining of admissions, etc. ( 7 ). Italian clinicians and researchers from the Lombardy province have stressed that practitioners should be equipped with appropriate e-health technologies and procedures to cope with epidemic conditions.…”

Associations Between Resilience, Psychological Well-Being, Work-Related Stress and Covid-19 Fear in Forensic Healthcare Workers Using a Network Analysis

“…This means that on top of working with a difficult patient group, forensic healthcare workers also had to deal with the Covid-19 pandemic and the measures that were taken. Several measures were implemented that have altered working environments, such as mandatory lockdowns, social distancing measures, wearing masks, learning new techniques and skills related to hygiene, disinfection, telemedicine, quarantining of admission, and fewer therapeutic sessions with patients (25). At the time of the survey, there was a relaxation of the restrictive Covid-19 measures in both the Netherlands and Belgium.…”

Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study

“…Short-term strategies at present emphasise prevention of transmission of infection in secure hospital settings but should also include patient and staff education and motivation work emphasising the need for vaccine uptake. 42 We believe that this is relevant to decisions regarding the prioritisation of vulnerable groups for accessing COVID-19 vaccination programmes. 43…”