Occupational Therapy News OTNews March 2020 | Page 22

FEATURE FORENSIC SERVICES
Many wanted more equality between the rich and
poor, others were preoccupied by specific issues such
as homelessness, the environment and what would
happen after Brexit.
A few were drawn to statements such as ‘tougher
sentences for serious crime’, raising questions about
what this could mean for them, and also to policy
concerning the future of NHS services, in terms of their
own care.
All of this seemed to stimulate thought about the
future, something that I have noticed can generally
be challenging for this client group, for whom leaving
hospital after a long admission could be a particularly
daunting prospect.
Finally, the act of voting itself seemed to create
an atmosphere of excitement and anticipation in the
café, as well as a sense of community in the shared
experience. dependent on my own understanding of some of the
more complicated political ideas.
With that also came the challenge of avoiding bias in
the way that we spoke about politics, although this was
difficult as we found we automatically knew more details
about policies by the parties we supported and may
have spoken about them in a more positive way.
I got the sense that service users enjoyed and felt
empowered by the voting process. When asked about
how it felt to cast her vote, one service user said: ’It felt
nice, I feel valued’. inclusion is central to our interventions within forensic
services, yet it is essential to consider it in all aspects of
our work.
As a continuation of the work around the election, I
intend to introduce a current affairs group, to encourage
service users’ ongoing engagement in the socio-political
environment.
The restrictions of medium-security present
barriers to social inclusion and links to the community,
however this is an argument for greater efforts to be
made by inpatient services to bring social inclusion
in through activities and interactions when they
cannot be accessed outside, in hope of disrupting
institutionalisation and promoting recovery.
Challenges
There was a potential risk that this exercise might
instead reduce confidence and hope by reminding
our service users of their disenfranchisement, as well
as the lack of choice they have in many areas of their
lives.
I was especially aware of this given that the results
of their vote were markedly different from those of the
public vote.
However, I believe it is important to frame this as
an aspect of learning and skills building, including
confidence and resilience in the face of disappointment,
to make informed choices and to have realistic
expectations for the future, rather than giving
false hope (Mezey et al 2010).
Another challenge was in
communicating information about the
election and the political parties.
It was important for
me to simplify the
information
to be
accessible,
but at
the same
time to
convey it
accurately.
This was a
task that was also
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22 OTnews March 2020
Empowering service users
The main thing I took from this project was that it was
not specifically about the act of voting or how service
users voted, but rather what this represented in terms of
exercising choice and engaging with the socio-political
environment.
My sense was that the process empowered service
users, by providing them with a platform to express
views and have these validated.
There are of course challenges to ensuring that social
References
Mezey G and Eastman N (2009) Choice and social inclusion
in forensic psychiatry: acknowledging mixed messages
and double think, Journal of Forensic Psychiatry and
Psychology, 20(4): 503-507
Mezey GC, Kavuma M, Turton P, Demetriou A and Wright C
(2010) Perceptions, experiences and meanings of
recovery in forensic psychiatric patients, Journal of
Forensic Psychiatry and Psychology, 21(5): 683-696
Rees G (2010) Suffrage or suffering? Voting rights for
psychiatric in-patients, British Journal of Psychiatry,
197(2): 159
Rees G and Reed J (2016) Patients or prisoners? Time to
reconsider the voting rights of mentally disordered
offenders, BJPsych Bulletin, 40(4): 169-172
Jessica Oglethorpe, senior occupational therapist,
Forensic Mental Health Services, South West London
and St George’s Mental Health NHS Trust, email:
[e-mail]