What does social distancing mean for patients in forensic mental health settings?

Tomlin, Jack

doi:10.1016/j.fsiml.2020.100018

Cited by 14 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Forensic mental health services have implemented service-wide changes in practice in response to the pandemic. Systematic reviews [e.g., ( 20 )] and various commentaries ( 6 , 9 , 10 ) have described how the COVID-19 pandemic has impacted psychiatric and mental health facilities and professionals globally. However, there is no empirical work to-date examining how these changes have affected forensic service outcomes, including frequency of incidents of violence, restrictive interventions, and service user level of risk.…”

Section: Introductionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Forensic Mental Health Services and Clinical Outcomes: A Longitudinal Study

et al. 2022

View full text Add to dashboard Cite

BackgroundThe COVID-19 pandemic has had a substantial impact on forensic mental health service provision and implementation. This study aimed to provide an analysis of the impact of COVID-19 related restrictions on routine outcomes within a large forensic mental health service in London, UK.MethodWe conducted a longitudinal cohort study using data collected routinely prior to the COVID-19 pandemic (April 2018–March 2020) and then stages thereafter (March 2020–March 2021; analyzed as March–May 2020, June–September 2020, October–December 2020, January–March 2021). We used causal impact models (Bayesian structural time-series) to examine the effect of COVID-19 related changes on routine outcomes related to service provision and implementation.ResultsThere was an overall increase in long-term segregation (LTS) hours during the pandemic; 140%, (95% Cl 107, 171%) during Lockdown 1; 113%, (159% Cl 127, 192%) during post-Lockdown 1; 45% (95% Cl 23, 68%) during Lockdown 2 and, finally, 90% (95% Cl 63, 113%) during Lockdown 3. The most negative outcomes were evident during Lockdown 3. Incidents of violence were significantly more frequent during Lockdown 3 than would have been predicted based on pre-pandemic data, including physical assaults to service users (206%, 95% CI 57%, 346%), non-physical assaults to service users (206%, 95% CI 53%, 339%), and self-harm (71%, 95% CI 0.4%, 135%). Use of enforced medication also increased during Lockdown 3 (317%, 95% CI 175%, 456%).ConclusionThe pandemic and its related restrictions negatively affected some service outcomes. This resulted in increased incidents of violence and increased use of restrictive interventions, beyond what would have been expected had the pandemic not occurred.

show abstract

Section: Introductionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Forensic Mental Health Services and Clinical Outcomes: A Longitudinal Study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The front-line reports of staff and patients in our sample echo and expand on the challenges of outbreak in other mental health settings as identified in recent studies [4,[9][10][11][12][13][14]. This suggests that while the changes to care and difficulties therein are known, specific strategies and resources to overcome these difficulties are not readily available to front-line staff.…”

Section: Discussionmentioning

confidence: 70%

“…Individuals confined to secure psychiatric environments are more vulnerable to the coronavirus disease (COVID-19) due to their physical and psychiatric comorbidities, the challenges of early release, and facilities and inpatient environments often not being designed to achieve sustained social distancing [1,2]. While necessary to protect the public, the restrictions placed on patients in forensic inpatient environments also bring negative consequences, including violent events and deterioration of mental status [3], poor ward atmosphere, and patient experiences of punitiveness and violation of dignity [4].…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Survey of Patients and Staff on Inpatient Forensic Psychiatric Units During COVID-19 Outbreak.

et al. 2021

View full text Add to dashboard Cite

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 [1]. 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.

show abstract

“…Some prison authorities have issued a ‘no-visitor’ directive for the time being. Nonetheless, individuals' perception of further restriction while being incarcerated during the pandemic is still a focus of investigation ( Tomlin, 2020 ). In one of the prison services, a holding area had been set up in a medium security prison where newly admitted prison in-mates are held for a period of fourteen days before they are transferred to the maximum security prison to which they had been originally remanded.…”

Section: Infection Controlmentioning

confidence: 99%

Forensic mental health service implications of COVID-19 infection in Nigeria

Ogunwale

Majekodunmi

Ajayi

et al. 2020

Forensic Science International: Mind and Law

View full text Add to dashboard Cite

Forensic mental health services are fledgling in most African countries including Nigeria. The current formulation of such services in Nigeria is correctional psychiatry in addition to some hospital-based services. The COVID-19 pandemic presents significant challenges to the already fragile state of forensic mental health services within the country. Its impact includes limitation of access to and continuity of mental healthcare in prison as well as reduction in referrals from other services within the criminal justice system such as the police and the courts. Further tapering of previously less prominent aspects of forensic mental health service in the country such as the preparation of psychiatric court reports has also been observed. Forensic psychiatry training and research have equally been hampered by the pandemic. The lessons learnt from these challenges should offer practitioners and policy makers insight into strategic developmental objectives for the post-COVID era within services and training programmes.

show abstract

What does social distancing mean for patients in forensic mental health settings?

Cited by 14 publications

References 6 publications

The Impact of the COVID-19 Pandemic on Forensic Mental Health Services and Clinical Outcomes: A Longitudinal Study

The Impact of the COVID-19 Pandemic on Forensic Mental Health Services and Clinical Outcomes: A Longitudinal Study

A Cross-Sectional Survey of Patients and Staff on Inpatient Forensic Psychiatric Units During COVID-19 Outbreak.

Forensic mental health service implications of COVID-19 infection in Nigeria

Contact Info

Product

Resources

About