Occupational Therapy in the Prison Setting

By: Jessica Melton, OTS

History and Laws 1972: American Medical Association

1976: Estelle vs. Gamble

1983: NCCHC

8th Amendment

Current Trend:

Forensic Psychiatry

Occupational Therapy in a State Psychiatric Hospital

Paul McCarty, OTR works with mentally ill inmates who have been sent to the hospital for treatment.

He works with patients for an average of 12 weeks, but often they unexpectedly discharge back to prison.

Paul sees a need for OT in the actual prison setting…

Occupational Deprivation

RECIDIVISMA National Problem

What’s OT Got to Do With It?

Restlessness/agitation- poor emotional regulation

Social isolation decreased social participation/skills

Structured environment lack of problem-solving and adaptation skills

History/Background/No meaningful occupations poor self-esteem and self-efficacy

Occupational Adaptation

Prison Style

MISSION to facilitate the cognitive

abilities, social skills, life skills, and emotional regulation skills needed both to cope with prison life and develop the capacity for successful reentry through interventions that allow opportunity for occupational engagement and improved self-efficacy.

Impossible?? Tool-use policies Safety and Security Stigmas and Attitudes of other

professionals “Survival” mentality Life sentences Funding

The Vision Recidivism will decrease as a result of

occupational therapy programs in prisons.

Violence within the prisons will decrease due to decreased agitation.

Occupational therapy will bring a unique perspective to the evaluation and treatment of inmates that will begin a new trend in prison healthcare.

Goals/ObjectivesGOALS: 5 YEARS OBJECTIVES: 6 MONTHS

Reduce recidivism by increasing independent living skills.

Decrease prison violence and mental instability.

Increase quality of life and social participation of inmates.

Inmates will increase independence in daily living skills by improving cognition required for tasks.

Inmates will improve emotional regulation skills through group participation.

Inmates will increase self-efficacy via high-success rate tasks, and demonstrate a cooperative effort in group tasks.

Funding The Second Chance Act

Beaird Foundation

Involve the NCCHP or other NPO

Resources Needed MANPOWER! Support from community Alliances for transition period A Non-Profit Organization to support

project A Government agency or official to

endorse project Plenty of TIME to PLAN EVIDENCE conduct a study

GIMME THE MONEY! Proposed budget is for 5 years, since

federal grant expects long term goals to be projected for 5 years.

This will give time to show evidence of success and hopefully the government will choose to permanently fund OT in the prison system.

How Much? Treatment Supplies

Documentation/ Evaluation Supplies

Compensation for community members’ involvement/rental of space

Salaries for 2 OTs

Grand Total

8,000/year

1,000/year

20,000/year

130,000/year

159,000/year x 5 years=$795,000.00

Or, without OT salaries: $145,000

References

Anno, J.W. (1992). Crisis in correctional health care: The impact of the national drugcontrol strategy on corrective health services. Annals of Internal Medicine, 177 (1),71-77.

Glaser, J.B. (1993). Correctional health care: A public health opportunity. Annalsof Internal Medicine, 118 (2), 139-145.

Posner, M.J. (1992). The Estelle medical professional judgment standard: Theright of those in state custody to receive high-cost medical treatment.American Journal of Law and Medicine, 347 (1).

Schindler, V.P. (2000). Occupational therapy in forensic psychiatry. In Cotrell, R.P.(Ed.), Proactive approaches in psychosocial occupational therapy, 319-325.Thorofare, NJ: Slack, Inc.

Steler, L. & Whisner, S.M. (2007). Building responsibility for self through meaningfulroles: Occupational adaptation theory applied to forensic psychiatry. OccupationalTherapy in Mental Health, 23 (1), 69-84.

Townsend, E. & Wilcock, A.A. (2004). Occupational justice and client-centeredPractice: A dialogue in progress. Canadian Journal of OccupationalTherapy, 71 (2), 75-87.

Whiteford, G. (1997). Occupational deprivation and incarceration. Journal ofOccupational Science, 4 (3), 126-130.