Management of COVID-19 Response in a Secure Forensic Mental Health Setting.
Identifieur interne : 000426 ( Main/Corpus ); précédent : 000425; suivant : 000427Management of COVID-19 Response in a Secure Forensic Mental Health Setting.
Auteurs : Alexander I F. Simpson ; Sumeeta Chatterjee ; Padraig Darby ; Roland M. Jones ; Margaret Maheandiran ; Stephanie R. Penney ; Tania Saccoccio ; Vicky Stergiopoulos ; Treena WilkieSource :
- Canadian journal of psychiatry. Revue canadienne de psychiatrie [ 1497-0015 ] ; 2020.
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.
DOI: 10.1177/0706743720935648
PubMed: 32573397
PubMed Central: PMC7312094
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Simpson</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Chatterjee, Sumeeta" sort="Chatterjee, Sumeeta" uniqKey="Chatterjee S" first="Sumeeta" last="Chatterjee">Sumeeta Chatterjee</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Darby, Padraig" sort="Darby, Padraig" uniqKey="Darby P" first="Padraig" last="Darby">Padraig Darby</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Jones, Roland M" sort="Jones, Roland M" uniqKey="Jones R" first="Roland M" last="Jones">Roland M. Jones</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Maheandiran, Margaret" sort="Maheandiran, Margaret" uniqKey="Maheandiran M" first="Margaret" last="Maheandiran">Margaret Maheandiran</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Penney, Stephanie R" sort="Penney, Stephanie R" uniqKey="Penney S" first="Stephanie R" last="Penney">Stephanie R. Penney</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Saccoccio, Tania" sort="Saccoccio, Tania" uniqKey="Saccoccio T" first="Tania" last="Saccoccio">Tania Saccoccio</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Stergiopoulos, Vicky" sort="Stergiopoulos, Vicky" uniqKey="Stergiopoulos V" first="Vicky" last="Stergiopoulos">Vicky Stergiopoulos</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wilkie, Treena" sort="Wilkie, Treena" uniqKey="Wilkie T" first="Treena" last="Wilkie">Treena Wilkie</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32573397</idno><idno type="pmid">32573397</idno><idno type="doi">10.1177/0706743720935648</idno><idno type="pmc">PMC7312094</idno><idno type="wicri:Area/Main/Corpus">000426</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000426</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Management of COVID-19 Response in a Secure Forensic Mental Health Setting.</title><author><name sortKey="Simpson, Alexander I F" sort="Simpson, Alexander I F" uniqKey="Simpson A" first="Alexander I F" last="Simpson">Alexander I F. Simpson</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Chatterjee, Sumeeta" sort="Chatterjee, Sumeeta" uniqKey="Chatterjee S" first="Sumeeta" last="Chatterjee">Sumeeta Chatterjee</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Darby, Padraig" sort="Darby, Padraig" uniqKey="Darby P" first="Padraig" last="Darby">Padraig Darby</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Jones, Roland M" sort="Jones, Roland M" uniqKey="Jones R" first="Roland M" last="Jones">Roland M. Jones</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Maheandiran, Margaret" sort="Maheandiran, Margaret" uniqKey="Maheandiran M" first="Margaret" last="Maheandiran">Margaret Maheandiran</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Penney, Stephanie R" sort="Penney, Stephanie R" uniqKey="Penney S" first="Stephanie R" last="Penney">Stephanie R. Penney</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Saccoccio, Tania" sort="Saccoccio, Tania" uniqKey="Saccoccio T" first="Tania" last="Saccoccio">Tania Saccoccio</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Stergiopoulos, Vicky" sort="Stergiopoulos, Vicky" uniqKey="Stergiopoulos V" first="Vicky" last="Stergiopoulos">Vicky Stergiopoulos</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wilkie, Treena" sort="Wilkie, Treena" uniqKey="Wilkie T" first="Treena" last="Wilkie">Treena Wilkie</name><affiliation><nlm:affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Canadian journal of psychiatry. Revue canadienne de psychiatrie</title><idno type="eISSN">1497-0015</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32573397</PMID><DateRevised><Year>2020</Year><Month>06</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1497-0015</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jun</Month><Day>23</Day></PubDate></JournalIssue><Title>Canadian journal of psychiatry. Revue canadienne de psychiatrie</Title><ISOAbbreviation>Can J Psychiatry</ISOAbbreviation></Journal><ArticleTitle>Management of COVID-19 Response in a Secure Forensic Mental Health Setting.</ArticleTitle><Pagination><MedlinePgn>706743720935648</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1177/0706743720935648</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="UNASSIGNED">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.</AbstractText><AbstractText Label="METHODS" NlmCategory="UNASSIGNED">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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="UNASSIGNED">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.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="UNASSIGNED">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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Simpson</LastName><ForeName>Alexander I F</ForeName><Initials>AIF</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-0478-2583</Identifier><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chatterjee</LastName><ForeName>Sumeeta</ForeName><Initials>S</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-7439-3359</Identifier><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Darby</LastName><ForeName>Padraig</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jones</LastName><ForeName>Roland M</ForeName><Initials>RM</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-3335-4871</Identifier><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maheandiran</LastName><ForeName>Margaret</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Penney</LastName><ForeName>Stephanie R</ForeName><Initials>SR</Initials><Identifier Source="ORCID">https://orcid.org/0000-0002-5890-4163</Identifier><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Saccoccio</LastName><ForeName>Tania</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stergiopoulos</LastName><ForeName>Vicky</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilkie</LastName><ForeName>Treena</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Complex Care and Recovery Program, Centre for Addition and Mental Health, Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Can J 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