165 COVID-19 and social relationships 6 INTRODUCTION Worldwide the social distancing measures, imposed by governments in response to the COVID-19 pandemic, have resulted in increased feelings of loneliness, disconnectedness, and psychological distress (Ponnet, Hardyns, Anrijs, & Schokkenbroek, 2020; Vindegaard & Benros, 2020), even more in psychiatric populations compared with general populations (Hoffart, Johnson, & Ebrahimi, 2020; Kraaij-Dirkzwager, Tromp, & van der Torn, 2021). The influence of close ties and social relationships on maintaining mental and physical health, in particular during stressful life events, such as a pandemic, has beenwidely acknowledged (Kawachi & Berkman, 2001; Ozbay et al., 2007). Previous COVID-19 studies have reported the protective effects of social contact on loneliness, wellbeing, and depressive symptoms in general populations (Macdonald & Hülür, 2021; Sommerlad et al., 2021). At the same time, diminished contact with family and friends as well as reduced access to support from mental healthcare providers and disruption of daily routines, was associated with deterioratedmental health states in psychiatric populations during the COVID-19 pandemic (Kølbæk, Jefsen, Speed, & Østergaard, 2021; Sheridan Rains et al., 2021). Therefore, in times of a pandemic, the importance of continuity of mental healthcare and maintenance of social relationships or resources of support for vulnerable and psychiatric populations, should not be underestimated. To date, however, no research has focused on the impact of the COVID-19 restrictions on social relationships of forensic psychiatric patients – a vulnerable population characterized by severe mental disorders and delinquent behavior – who often lack a supportive social circle (Estroff et al., 1994; Murphy, 2000; ter Haar-Pomp et al., 2015). During the COVID-19 pandemic, social and familiar bonds of forensic patientsmay further decrease, as distancing measures are expected to exacerbate avoidant and negative attitudes towards stigmatized groups, such as forensic psychiatric patients who are often portrayed as dangerous and risky (Chaimowitz et al., 2021; Murphy, 2000). Furthermore, forensic patients require consistent and qualitatively imputed care, as social support is predominantly provided by (mental) healthcare professionals (e.g., social workers, nurses) and community services organizing daytime activities (Skeem et al., 2009). More specific, the importance of face-to-face appointments was emphasized, as a substantial part of forensic outpatients failed to use other sources of communication during the COVID-19 pandemic (Chaimowitz et al., 2021; de Beurs, Blankers, Goudriaan, de Koning, & Dekker, 2021). The interruption of routine appointments and transformation to virtual care in response to the COVID-19 restrictions, as well as the limited availability of social relationships, assumably leads to deteriorated psychosocial wellbeing of forensic patients (Chaimowitz et al., 2021; de
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