Feature
Supporting identity in a high secure hospital
How a creative activity project to explore stigma and identity is supporting patients at Rampton high secure hospital to reconstruct healthy feelings of self-worth .
R ampton is one of England ’ s three high secure hospitals . It provides a service to around 270 patients who require care and treatment in conditions of high security .
Patients admitted to forensic care , specifically high secure , experience labelling that has lifelong implications in terms of their future rehabilitation and recovery ( Williams et al 2011 ).
This labelling stems from negative associations with mental illness and / or criminal convictions , made either by the self or others , and is referred to as stigma . Stigma has been identified to negatively affect the severity of an individual ’ s symptoms , reduce feelings of hope or belief in recovery , and drastically degrade identity ( Cruwys and Gunaseelan 2016 ; Williams et al 2011 ).
Vulnerability , fear , anger , humiliation , and unworthiness are just some of the negative feelings that have been reported to be associated with being detained under the Mental Health Act 1983 ( Akther et al 2019 ).
The low self-worth that can be experienced here feeds directly into the stigma of being perceived as unfit to function in society and can cause a sudden break in identity or a sense of not having a complete identity ( Breakwell 1986 ).
Below : The personality disorder service at Rampton
Identity refers to how an individual perceives unique aspects of their personality . Memories , goals , values , expectations , beliefs and engagement in society all contribute to an individual ’ s self-perception ( Craib 1998 ).
Detainment under the Mental Health Act 1983 causes permanent and sudden changes to life situations and environment and can result in feeling a loss of stability , power and control ( Hughes 2019 ).
In addition to a possible lack of understanding of the process , it is apparent how the whole experience can be viewed as dehumanising and may impact on an individual ’ s identity .
Exploring identity through creative activities
Occupational therapists working within the personality disorder care stream at Rampton utilise a range of activities and work in a collaborative manner with patients in order to support them to adapt to this change and gain a greater sense of control over their lives .
To facilitate this exploration of identity , creative activities are used and adapted in a way that meets the needs of individual patients at varying stages of care .
Occupational therapists use grading and risk assessment in both treatment and intensive care wards to ensure patients are able to participate . This can include working through a door hatch with patients in long-term segregation .
Activities undertaken aim to deconstruct antisocial behaviours or negative life experiences , while encouraging service users to recognise positive aspects of their life to reconstruct healthy feelings of self-worth .
Co-facilitation and self-expression
One of the projects currently being worked on , which aims to explore personal interests and help
38 OTnews April 2022