{"id":8098,"date":"2018-11-30T15:24:31","date_gmt":"2018-11-30T15:24:31","guid":{"rendered":"https:\/\/www.talkingmats.com\/?p=8098"},"modified":"2018-11-30T15:24:31","modified_gmt":"2018-11-30T15:24:31","slug":"setting-up-an-slt-service-in-prison","status":"publish","type":"post","link":"https:\/\/www.talkingmats.com\/setting-up-an-slt-service-in-prison\/","title":{"rendered":"Setting up an SLT service in prison"},"content":{"rendered":"

This blog by\u00a0Jacqui Learoyd explores her role in setting up a speech and language therapy ( SLT )\u00a0 service in a prison and her use of Talking Mats in that setting .\u00a0HMP Berwyn is a large prison which opened in February 2017. To help you understand the challenges facing me when setting up this service in a new prison, I\u2019ll tell you something about prisons, the people in prison, and the healthcare provision at HMP Berwyn.<\/p>\n

In the UK the prison population is just growing and growing.\u00a0 The graphic above\u00a0 is taken from the Commons Library Briefing of April 2017 so that you can see the trend.\u00a0 The number of people in the prison system as of April 2018 is 83,617.\u00a0 The reoffending rate is about 30%.<\/p>\n

From this data alone, we can see that something needs to change in order to reduce offending and re-offending.\u00a0 Part of the \u2018something which needs to change\u2019 is considering offender rehabilitation \/ prison reform.\u00a0 This led to the building of the UK\u2019s newest prison \u2013 HMP Berwyn.<\/p>\n

We tend to shorten the name of the prison to just \u2018Berwyn\u2019, so that is what I will call it in this short piece.\u00a0\u00a0 Berwyn has a focus on rehabilitation and treating people as individuals. We aim for the provision of high quality healthcare.\u00a0 We have space for 2106 gentleman \u2013 which makes us quite a large facility.\u00a0 We also give attention to the words which we use in our daily conversations \u2013 the clients are not called prisoners, but \u2018men\u2019, the cells are \u2018rooms\u2019, people are called by their first names, etc.<\/p>\n

The healthcare provision is an integrated multidisciplinary team with a mix of professionals offering a range of skills.\u00a0 It\u2019s called the Health and Wellbeing Team as it offers holistic care to our clients.\u00a0 I\u2019m happy to say that this includes full time Speech and Language Therapy (SLT), which is where I come in.<\/p>\n

Speech and Language Therapy is necessary in a prison setting as a significant proportion of people in the criminal justice system will have speech, language and communication needs.\u00a0 Some research suggests that this may be as high as 91% (Brooks, 2011).\u00a0 Many of these people will not have accessed SLT in the past, and will have developed their own strategies in hiding their difficulties.\u00a0 This is why communication impairment is a hidden disability in this client group.\u00a0 Alongside this, people in prison experience much worse mental and physical health compared with the general population.\u00a0 There are more head injuries, more illnesses caused by drugs and alcohol, higher numbers of people with diagnosed mental illness and more people with conditions such as ADHD.\u00a0 The prison population is aging, so we have all the illness which link with an aging population too, such as strokes, dementia, cancers.\u00a0 You can see that as a service, we are going to be kept very busy!<\/p>\n

We\u2019ve got lots of plans for how to tackle some of the things which we want to do as an SLT service, but something which we have already achieved is using Talking Mats.<\/p>\n

My first thought was how the men at Berwyn would respond to a conversation using a set of symbols and a doormat.\u00a0 Needless to say, they took it to without question \u2013 even the toughest looking customers who had been \u2018inside\u2019 for many years happily sat down with me to chat using the tool.\u00a0 Not only did they tolerate the Talking Mat, but they loved it \u2013 reporting that they were able to organise their thoughts and report their views more easily.<\/p>\n

\"client<\/a>To start with (and to ease clients into this way of sharing information) we tried Talking Mats about the problems faced by individuals at Berwyn.\u00a0 The question was \u2018what do you feel about ________ at Berwyn?\u2019 with symbols for the experiences and situations that men face during the day.\u00a0 It looked something like this: You can see that this gentleman was having some problems with his mental health, his computer in his room (which is necessary to book visits and make purchases), his memory and his weight.\u00a0 Other aspects of his life were OK such as family contact and care from the doctor.<\/p>\n

Some clients wanted to say more about emotions following completing the \u2018problems\u2019 Talking Mat.\u00a0 We used a \u2018me\u2019\/\u2019not me\u2019 visual scale and symbols to represent emotions.\u00a0 This Talking Mat requires the client to have some emotional awareness skills so that they can recognise what they are feeling.\u00a0 Not all of the clients are at this stage, and it is especially hard for depressed people to access their emotions vocabulary (Bryan,2013).<\/p>\n

\"emotions<\/a><\/p>\n

Here is an example of this Talking Mat.\u00a0 This information could be used as a starting point to develop an emotions safety plan with an individual. After completing this Talking Mat with a 21 year old man who has a significant history of Adverse Childhood Events, he wanted to make his own Talking Mat about his life experiences.\u00a0 This is a young man who finds expressing his emotions and past very difficult. I was quietly excited that he was prepared to share more information.\u00a0 We have sat together and used the symbol software to make his symbols, and next week I will get to see what he is going to tell me.<\/p>\n

And lastly, we have met some clients who have a diagnosis of an Autistic Spectrum Condition.\u00a0 They had attracted this diagnosis during their teen or adult years, but had limited understanding of what Autism is or how it affects them on a personal basis.\u00a0 Being in prison, they can\u2019t Google to find out more as you and I might.<\/p>\n

\"my<\/a><\/p>\n

We have developed a Talking Mat which explores \u2018what is Autism?\u2019 and allows the client to learn while they report on what having autism feels like for them.\u00a0 We hope to develop the responses on this Talking Mat into a person centred communication passport which can be shared to help all their communication partners.<\/p>\n

We keep thinking about \u2018what next?\u2019 with the clients and the SLT service, and we continue to develop symbol sets for more Talking Mats conversations.\u00a0 Often we are being led by the clients in terms of what they need in Talking Mat form.<\/p>\n

We have strong links in the wider team, so will be doing more Talking Mats work with psychology, substance misuse and nursing colleagues.\u00a0 We hope to access the Talking Mats Accredited Training and expand the number of people using Talking Mats to include Offender Managers and Prison Officers.\u00a0 Alongside this we are developing healthcare pathways for clinical work such as end of life care, so will be applying the Talking Mats methodology to advanced care planning.\u00a0 There\u2019s a lot to do!<\/p>\n

Postscript\u00a0<\/span><\/p>\n

If any of you want you to link with Jacqui to discuss this further please let us know and we will link you\u00a0with her. If you want to become confident and skilled at using Talking Mats then please come on a training\u00a0<\/a>\u00a0We also have an online course<\/a><\/p>\n

References<\/strong><\/p>\n

Brooks, V., 2011. Report outlining the findings of a 13 month pilot project examining the effectiveness of speech and language therapy for young people known to Exeter, East and Mid Devon Youth Offending Team. East and Mid Devon Youth Offending Team<\/em>.<\/p>\n

Bryan, K. (2013). Psychiatric disorders and communication. In L. Cummings (Ed.), The Cambridge Handbook of Communication Disorders<\/em> (Cambridge Handbooks in Language and Linguistics). Cambridge: Cambridge University Press. doi:10.1017\/CBO9781139108683.020<\/p>\n","protected":false},"excerpt":{"rendered":"

This blog by\u00a0Jacqui Learoyd explores her role in setting up a speech and language therapy ( SLT )\u00a0 service in…<\/p>\n","protected":false},"author":4,"featured_media":8100,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[85,24,25],"tags":[13,23,26,28],"class_list":["post-8098","post","type-post","status-publish","format-standard","hentry","category-autism","category-communication-difficulties","category-criminal-justice","tag-talking-mats","tag-communication-difficulties","tag-justice","tag-prison"],"acf":[],"yoast_head":"\nSetting up an SLT service in prison - Improving Communication, Improving Lives<\/title>\n<meta name=\"description\" content=\"Explores setting up a speech and language therapy service in a prison and her use of Talking Mats in that setting to support prisoners to express themselves\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.talkingmats.com\/setting-up-an-slt-service-in-prison\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Setting up an SLT service in prison - 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