History of Forensic OT
Under which setting does OT in Forensic Psychiatry fall?
Community practice (AOTA, 2016).
Community practice OT, "refers to the delivery of services in natural settings, such as schools, day-care centers, community centers, housing units, homeless shelters, places of worship, work sites, health care settings, or community agencies, versus institutional settings"(Vanier & Hebert, 1995).
In what settings can Forensic Mental Health OTs work?
Community based settings, in prisons, transition care, psychiatric facilities, vocational rehab, residential settings (AOTA, 2018)
Community-based setting- Care and treatment after incarceration
Transition care- helping clients make the transition from prisons life to society
Vocational rehab- job training and skill development to be used after incarceration
The United States makes up about 5% of the world's population. What percentage do we hold of the world's prison population?
21%
If America's jail population was a city, it would be the 5th largest city in the US, behind Houston, TX (CNN, 2018).
What other disciplines are commonly serving in this setting?
Nursing, social work, psychiatry, psychology, rec therapy, and religious figures (Chui et al., 2016).
What is the central component of evaluation in this setting?
Interview that determine’s a client’s functioning and their insight into the nature of their offense (Chui, 2016)
During what social movement or time period did OTs become involved in mental health?
In the 1960s, occupational therapy as a profession was heavily involved in the deinstitutionalization of mental health facilities, (AOTA, 2013).
What are the most reported goals of clients in the Criminal Justice System?
Productivity, IADLs, ADLs, Emotional Management and Life and Leisure engagement (Chui et al., 2016).
African Americans and Latinx people make up about 32% of the US population. What percentage of the US prison population do they make?
56%
That is more than double (NAACP, 2019)
Where might services for those involved in the criminal justice system be found?
Private and public hospitals, forensic and juvenile justice centers, residential and day programs, community-based mental health centers, schools, employment programs, outpatient clinics (AOTA, 2016).
What are some areas of occupation that OTs can intervene in this setting?
IADLs/ADLs, vocational skills, leisure
What OT model most directly relates to Forensic Psychiatry and OT?
The Recovery Model is based on the evidence that those with mental illness can and do recover to lead meaningful, satisfying, and productive lives (AOTA, 2016).
Is this in our scope of practice?
84% of the clinicians report using the OTPF to guide treatment (Chui, 2016).
What percentage of women in the US Criminal system reported sexual assault in their lifetime?
Nearly 60% (ACLU, 2011).
ACLU also reports that being in the justice system leaves them vulnerable to revictimization.
Who may support/refer clients experiencing incarceration to services?
Case managers, Department of Juvenile Services, Department of Justice, Department of Social Services, a psychiatrist.
"With the call for deinstitutionalization of individuals with mental illness, which culminated in the 1963 Community Mental Health Act, occupational therapists and occupational therapy assistants began working in community mental health" (Scheinholtz, 2010).
How can OTs intervene in planning for release?
Establishing life skills such as self-care, education opportunities, vocational training (Herlache-Pretzer & Jacob, 2018)
Which legislation was integral to the deinstitutionalization movement in 1963?
Community Mental Health Act of 1963 was signed by JFK to authorize federal grants for the creation and maintenance of community-based, public mental health programs (NCBH, n.d.).
What can we do other than clinical work in the US justice system?
Positive changes for marginalized groups through advocacy, education, and research (Chui, 2016).
How much does the US spend on corrections each year?
$81 billion
"Spending on prisons and jails has increased at triple the rate of spending on Pre‐K‐12 public education in the last thirty years" (NAACP, 2018).
Are you familiar with any existing OT programs targeted at this population?
Sheppard Pratt’s Mann Residential Treatment Center (adolescents)
Mission: “To improve the quality of life of individuals and families by compassionately serving their mental health, addiction, special education, and community support needs” (Sheppard Pratt Health System, 2014, p. 1).
Allegheny County Jail Collaborative (Pittsburgh, PA)
Mission: “The Allegheny County Jail Collaborative aims to reduce recidivism and thereby improve public safety, restrain the growth in Jail costs, and prevent the disintegration of communities and families impacted by crime and incarceration” (Allegheny County Jail Collaborative, 2016, p. 1)
What are some novel treatment techniques that are gaining popularity in the corrections setting?
Animal companion programs
Level I fieldwork students participating in life skills programs (Herlache-Pretzer & Jacob, 2018)