Vocational Rehabilitation within Forensic services.
“The development of a vocational pathway in forensic services.” Pollard K Northumberland, Tyne and Wear NHS Foundation Trust.
“Real work matters on a high dependency ward within a high secure environment.” Robertson CJ, Russell S, West London Mental Health NHS Trust, First Step Trust UK.
“Are you bored? Looking at boredom in a forensic in-patient setting.” Ayles K. Kent and Medway NHS and Social Care Partnership Trust.
Key points from these papers:
- There are many barriers for forensic patients wanting to maintain or find employments, these could include: Self image, Societal preconceptions, lack of appropriate/transferable skills, inappropriate behaviours, mental health problems, anxieties.
- Pre-vocational skills are needed in order to build on achieving an occupation/paid employment. Steps in order to achieve this could include group work, individual goal plans to achieve existing therapeutic programmes, developing social skills, employ-ability and personal development programs.
- Promote work as part of recovery and eventual inclusion into society.
- Create paths which make patients seem and feel as if they have left the ward.
- Importance of social skills/social inclusion when leading groups. Eventually as OTs to facilitate the group rather than to lead.
- Boredom in forensic units is extremely high and can stem from occupational deprivation (as defined in a previous blog entry). Within the study on boredom participants revealed that they perceived and described being bored as a negative emotion. - "frustrating", "worthless", "numb" etc.
- Few patients within the unit engaged in solitary time in their rooms as they feared it would be viewed negatively by staff.
- Patients revealed that previous coping strategies to boredom where illegal and/or antisocial - as a forensic OT one challenge lies in replacing these coping strategies which positive ones.
- Recommendations for tackling boredom:
- Ensure activities are interesting and meaningful.
- Introduce new/taster sessions to help patients.
- Make clear links between groups and the skills acquired.
- Provide adequate activities for those without leave from the ward.
- Increase resources, including people, evenings and weekends.
- Enhance work experience opportunities.
- Explores additional opportunities for education.
- Increase access to books and DVDs.