Forensic Forum - Paper Session.

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:

1. Ensure activities are interesting and meaningful.
2. Introduce new/taster sessions to help patients.
3. Make clear links between groups and the skills acquired.
4. Provide adequate activities for those without leave from the ward.
5. Increase resources, including people, evenings and weekends.
6. Enhance work experience opportunities.
7. Explores additional opportunities for education.
8. Increase access to books and DVDs.