The impact of the COVID-19 pandemic on the psychosocial rehabilitation of forensic psychiatric patients in Austria

Koch, M.; Dvorak, Alexander; Hobersdorfer, M.; Yeghiazaryan, Lusine; Rabl, Ulrich; Komorowski, Arkadiusz

doi:10.1016/j.ijlp.2023.101889

Cited by 2 publications

(7 citation statements)

References 21 publications

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“…To our knowledge, this is the first study attempting to explore whether the COVID-19 pandemic was related to significant changes in the pattern of forensic admissions for acute psychiatric care in Switzerland. To date, only two samples in forensic settings examined the longitudinal evolution of care needs during the whole duration of COVID-19 pandemic ( 24 , 25 ). As already reported by Koch et al ( 24 ) we did not observe a significant increase of the number of admissions in our acute ward during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only two samples in forensic settings examined the longitudinal evolution of care needs during the whole duration of COVID-19 pandemic ( 24 , 25 ). As already reported by Koch et al ( 24 ) we did not observe a significant increase of the number of admissions in our acute ward during the COVID-19 pandemic. This may be related to the fact that since prison is a more controllable place, isolation rules are easy to regulate and do not induce an overall psychological burden sufficiently severe to induce increased needs for inpatient psychiatric care.…”

Section: Discussionmentioning

confidence: 99%

“…Two main differences could explain the discrepancy of these results. First, both longitudinal studies ( 24 , 27 ) concerned medium and low security rehabilitation settings with very long duration of stays. Second and in respect to the data from United Kingdom, strict lockdown with major restriction of social contacts was not decided in Switzerland.…”

Section: Discussionmentioning

confidence: 99%

“…These observations concern a specialized unit of forensic psychiatry located in prison and not in a psychiatric hospital. The effect of COVID-19 pandemic may be radically different in low security settings that guarantee better social support and access to reliable information ( 24 ). In the same line, our findings cannot be compared with those made in long-term rehabilitation centers for patents with court-ordered treatments.…”

Section: Discussionmentioning

confidence: 99%

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Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

D’Orta,

Herrmann,

Giannakopoulos

2024

Front. Psychiatry

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IntroductionThe impact of COVID-19 pandemic on forensic service practice remains matter of debate. Increased rates of anxiety, depression, and exacerbation of psychotic symptoms were reported in the early phases of the pandemic among detained persons. However, longitudinal analyses in medium-security hospitals taking into account the whole pandemic period led to mitigated results.MethodsThis report examines the evolution of the type (voluntary versus involuntary) and reason of admissions, length of stay, history of outpatient care, short-term seclusion hours for aggressive behaviors, and clinical diagnoses for detainees needing acute psychiatric care during the COVID-19 pandemic in the sole secure ward located in the central prison of Geneva, Switzerland. To determine the general trend of the processes over time we applied a combination of process analysis with run chart plotting, and fractional polynomial regression.ResultsRun tests showed that the proportion of cases with personality disorders, substance use disorders (SUD), and previous outpatient care tended to increase during the COVID pandemic with subsequent decrease to reach the pre-COVID values. This was also the case for depressive symptoms as reason for admission. The proportion of involuntary admission showed a steady increase both during the COVID and post-COVID time periods. In contrast, short-term seclusion hours decreased during the COVID pandemic followed by a return to their pre-COVID values. Regression models revealed that the COVID pandemic was associated with a significant increase in the rates of inmates with personality disorders and SUD admitted for forensic care explaining 36 and 41% of their variance.DiscussionThese data support the idea that, in terms of acute care needs, the COVID-19 pandemic was associated with increased needs for acute forensic care that concerned detainees with personality disorders characterized by increased levels of impulsiveness, decreased tolerance to frustrations, loss of control, increased extraversion and frequent SUD comorbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

D’Orta,

Herrmann,

Giannakopoulos

2024

Front. Psychiatry

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“…The global prison population is estimated to exceed 11.5 million, and people living in prison (PLP) commonly face challenges that impact their health, social reintegration, and life expectancy ( 1 , 2 ). While elevated rates of communicable diseases result in higher mortality rates ( 3 ), a large part of the prison population is also affected by a psychiatric disorder ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Psychiatric and legal considerations for ketamine treatment within prison settings

Bayrhammer-Savel,

Ortner,

Van Hout

et al. 2024

Front. Psychiatry

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The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors’ perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations.

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The impact of the COVID-19 pandemic on the psychosocial rehabilitation of forensic psychiatric patients in Austria

Cited by 2 publications

References 21 publications

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

Psychiatric and legal considerations for ketamine treatment within prison settings

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