Forensic: Challenges for OT
When institutionalized, individuals are unable to choose meaningful occupations and are only able to perform certain occupations when permitted which results in a lack of autonomy and control (Ozkan et al., 2018). Individuals often report feeling bored, frustrated, and occupationally alienated (Craik et al., 2010). Facilities often have an impoverished occupational environment in general. Due to safety, occupations are also often only at designated times, locations, and have limited resources (Craik et al., 2010). Level of security, opportunities for occupational participation, availability of meaningful occupations, and participation with strangers were reported as barriers to participation. Overall, a lack of autonomy, control, and unstructured time use has the potential to impact an individual's routines, habits, and volition (Ozkan et al., 2018). Occupational deprivation is also a barrier to occupation-based treatment (Craik et al., 2010).
OT is a frequently misunderstood profession (Newton, 2007). Furthermore, forensic OT is still considered an emerging practice area that requires further research to gain more understanding and guidance about OT's role and the effectiveness of treatment. Although OT has been involved in the mental health field for over 70 years, it's role is still unclear (Rojo-Mota et al., 2017). This could be due to the limited amount of research performed that supports OT's role in the mental health setting (Rojo-Mota et al., 2017). Limited research, a lack of practice guidelines, and being misunderstood by other members on their interdisciplinary team pose challenges for an OT in this practice area (Royal College of Occupational Therapists, 2017).
Little funding is allocated to rehabilitative services for these populations. Meanwhile, OT treatment comes at a high cost (Pergolotti et al., 2018), especially when compared to many other services.