Purpose

The aim of this study is to gain a better understanding of the concerns and needs of forensic psychiatric patients regarding the impact of the COVID-19 crisis on their mental health and treatment.

Design/methodology/approach

Semi-structured interviews were conducted with nine patients from various wards of the hospital. Using the consensual qualitative research method, these interviews were coded by a team of three researchers.

Findings

Four domains emerged from the analysis, namely, restrictions, emotional consequences, coping and communication. One of the primary restrictions for patients was not being allowed to have physical contact with the people in their network/visitors. This prompted patients, in some cases, to decline visitors altogether. Emotional consequences of the COVID-19 measurements included anxiety, frustration and passivity. Ambiguity about the rules added to this frustration. Furthermore, a cut in autonomy was felt by patients due to them not being able to do their own grocery shopping. Despite these restrictions that were imposed on patients, the relationship between patients and staff was perceived as good and even improved according to the participants.

Practical implications

A lack of autonomy emerged as a salient issue related to the restrictions within the hospital. Certain degrees of control may be inevitable, but it is nonetheless important to focus on the effect of control within forensic settings. This could be done by aiming to actively include patients in decisions that affect their living climate. Furthermore, it appeared that the “ballet dancer” approach was used by the staff of the hospital, leaving more room for individualized care. As perceived support is important to increase willingness to accept the treatment being offered, a focus on this approach in times of rapid change such as during a pandemic, would be recommended.

Originality/value

Because few pandemics have occurred in the past century, little information is available about how a pandemic might affect patients residing in forensic psychiatric hospitals. To the best of the authors’ knowledge this is one of the first studies to assess concerns and needs of forensic psychiatric patients regarding the COVID-19 pandemic.

中文翻译：

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COVID-19 时期的法医精神病学：对患者关注和需求的定性研究

目的

本研究的目的是更好地了解法医精神病患者对 COVID-19 危机对其心理健康和治疗的影响的担忧和需求。

设计/方法/方法

对来自医院不同病房的九名患者进行了半结构化访谈。使用双方同意的定性研究方法，这些访谈由三名研究人员组成的团队编码。

发现

分析中出现了四个领域，即限制、情绪后果、应对和沟通。对患者的主要限制之一是不允许与其网络/访客中的人进行身体接触。在某些情况下，这促使患者完全拒绝访客。COVID-19 测量的情绪后果包括焦虑、沮丧和被动。对规则的模棱两可加剧了这种挫败感。此外，由于患者无法自行购买杂货，患者的自主权受到削弱。尽管对患者施加了这些限制，但根据参与者的说法，患者与工作人员之间的关系被认为是良好的，甚至有所改善。

实际影响

缺乏自主权成为与医院内部限制相关的一个突出问题。一定程度的控制可能是不可避免的，但在法医环境中关注控制的效果仍然很重要。这可以通过积极让患者参与影响其生活环境的决策来实现。此外，医院工作人员似乎使用了“芭蕾舞演员”的方法，为个性化护理留下了更多空间。由于感知支持对于增加接受所提供治疗的意愿很重要，因此建议在大流行期间等快速变化时期关注这种方法。

原创性/价值

由于在过去的一个世纪中很少发生大流行，因此关于大流行如何影响法医精神病院的患者的信息很少。据作者所知，这是首批评估法医精神病患者对 COVID-19 大流行的担忧和需求的研究之一。