Sensory Processing, Occupational Therapy and Forensic Mental Health
Research type
Research Study
Full title
An Occupational Therapy Perspective of Sensory Processing and Occupational Participation in Forensic Mental Health: A Phenomenological Study.
IRAS ID
241687
Contact name
Elana Moore
Contact email
Sponsor organisation
University of Plymouth
Duration of Study in the UK
1 years, 6 months, 24 days
Research summary
Summary of Research
The ability to process sensory information (sight, sound, taste, touch, vestibular (balance), proprioception (body position)) is fundamental to an individual’s ability to understand and respond to their environment and participate in occupations (activities which have meaning). Forensic mental health refers to services provided for individuals deemed a risk because of complex mental health issues, which frequently result in the involvement of the criminal justice system. Occupational therapy focuses on supporting individuals to overcome challenges which impact on participation in occupations. Occupational therapists play a key role in the multi-disciplinary team working with forensic mental health service users, to support the development of daily living and community skills through participation in occupations.
Research indicates mental health service users have sensory processing needs which impact their ability to participate in occupations. There is, however, no clear guidance on how sensory processing information could be used to enhance occupational therapy in forensic mental health settings. It is anticipated this research will generate information regarding the utility of sensory processing in this setting.
This exploratory research will focus on the experiences of sensory processing and the influence this has on occupational participation for forensic mental health service users. Two studies will collect data about the phenomenon, sensory processing, and its influence on occupational participation, from the perspective of forensic mental health occupational therapists and then from the perspective of service users.
The first study will gather qualitative data from occupational therapists. This study does not require HRA approval as clinicians will not be recruited via the NHS or participate in NHS time.
The second study will collect quantitative assessment data from service users who have agreed to be interviewed. This assessment data will be used as a standalone data set and be used to shape questions for semi-structured interviews. This study requires HRA approval.
Summary of Results
The ability to process sensory information (sight, sound, taste, touch, vestibular (balance), proprioception (body position)) is fundamental to an individual’s ability to understand and respond to their environment and participate in occupations (activities which have meaning). Forensic mental health refers to services provided for individuals deemed a risk because of complex mental health issues, which frequently result in the involvement of the criminal justice system. Occupational therapy focuses on supporting individuals to overcome challenges which impact on participation in occupations. Occupational therapists play a key role in the multi-disciplinary team working with forensic mental health service users, to support the development of daily living and community skills through participation in occupations.
This HRA approved service user study formed part of the Chief Investigator’s doctoral research. The study aimed to explore service users’ lived experiences of sensory processing and its influence on occupational participation in forensic mental health settings, to inform a framework for practice. A separate study explored occupational therapists’ practice-based experiences.
Five service users participated, achieving the sample target number.Informed by a phenomenological research approach, the findings from this study, combined with the occupational therapist study and a scoping review, were analysed separately. The findings were then combined to construct the final meanings for the research.
The four meanings established are: 1) environment impacts recovery; 2) activity opportunities are important but barriers limit participation; 3) patient or prisoner: rules prevail as therapy loses out to security; 4) occupational therapists are experiencing professional identity challenges.These findings suggest that some forensic mental health inpatient services, including those with occupational therapy interventions, are not directly addressing sensory processing needs. Further, the sensory environment impacts the overall experiences of those who use and facilitate occupational therapy in these settings.
This research has generated new knowledge which recommends occupation focused therapy, environmental improvements, and activity pathway suggestions for all stages of recovery, to support health and well-being.
To improve the quality of services, these environmental and activity opportunities should holistically address sensory processing needs to support service users’ participation in meaningful occupation.
A service review and future research which focuses on the potential injustices in the environment, and how this impacts activity participation, would be beneficial. The use of participatory research would empower service users in these discussions.
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
21/NW/0262
Date of REC Opinion
28 Sep 2021
REC opinion
Favourable Opinion