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

Outbreaks of the coronavirus disease (COVID-19) on inpatient forensic psychiatry units present a unique challenge as early release is not possible and some facilities were not designed to achieve sustained social distancing. The enforcement of droplet and contact (D&C) precautions required by Public Health Ontario during an outbreak creates further confines and restrictions for patients that are typically subject to considerable constraints during their care. From December 2020 to January 2021, 30 clinicians and 12 patients on inpatient forensic psychiatry units under unit-wide D&C precautions during COVID-19 outbreaks completed a cross-sectional survey about their experience. We also conducted virtual focus groups to triangulate the qualitative feedback from clinicians. The survey and focus group discussions revealed similar themes of enablers, barriers, and desired changes to care provision during an outbreak. We discuss findings within the broader context of outbreak interventions and the provision of services to those living and working on forensic psychiatry inpatient units experiencing outbreaks requiring the unit-wide implementation of D&C precautions.

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Kratom-Induced Psychosis: Case report and literature investigation

Substance use disorder is a major concern for public health. Legal substances are often misused to get high. Beside the risk of developing subsequent mental health and physical conditions, one of major risk is related to behavioural changes leading to criminal behaviour. Some of these substances need regulation to ensure public as well as individual safety. This article is a case report describing Mitragyna speciosa (Kratom) induced psychosis in a patient suffering from Schizophrenia. We hope this article can bring attention to regulating bodies about the risks associated with readily available “legal” drugs like Kratom.

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