SENSING FREEDOM: AN OCCUPATIONAL THERAPY AND SERVICE USER PERSPECTIVE OF SENSORY PROCESSING AND OCCUPATIONAL PARTICIPATION IN FORENSIC MENTAL HEALTH

Abstract

Abstract: Elanor Moore: Sensing Freedom: An Occupational Therapy and Service User Perspective of Sensory Processing and Occupational Participation in Forensic Mental Health

Background Sensory processing is a universal dynamic mind-body process which all individuals experience. It is influenced by the environment and impacts participation in occupations. Occupational therapists in forensic mental health inpatient settings aim to facilitate occupationally enriching opportunities, to support service users’ safe community reintegration. Emerging evidence indicates links between sensory processing and mental health, but with limited guidance on how this translates into occupation-focused practice.

Methodology A scoping review identified both inconsistency in sensory processing terminology and a limited focus on occupation. This review informed the research methodology: subtle-realism and constructionism. A hermeneutic phenomenological framework supported the exploration of the lived experience of sensory processing and occupational participation in forensic settings through two studies. Study One interviewed eight occupational therapists and Study Two interviewed five service users. A reflexive thematic analysis with a hermeneutic circle was used to acknowledge researcher/clinician positionality.

Findings and discussion The four meanings established are: environment impacts recovery; activity opportunities are important but barriers limit participation; patient or prisoner: rules prevail as therapy loses out to security; occupational therapists are experiencing professional identity challenges. These findings indicate that forensic mental health inpatient services, including occupational therapy, are not directly addressing sensory processing needs in this environment which impacts the overall experiences of those who use and facilitate recovery in these settings.

Conclusion This research has generated new knowledge which recommends environmental improvement, and activity pathway suggestions for all stages of recovery, to support health, well-being and recovery. To improve the quality of services, these environment and activity opportunities should holistically address sensory processing needs to support participation in meaningful occupation. A service review and future research into occupational justice would be beneficial, focusing on the environment and activity. The use of participatory research would empower service users in these discussions.