Towards work in forensic mental health: national guidance for allied health professionals: a review to government

Jean McQueen

Research output: Book/ReportCommissioned report


This report was commissioned by the Scottish Government and is supported and endorsed by the Forensic Network. It follows the publication of ‘Realising Potential: An action plan for Allied Health Professionals in mental health’ (2010). This document made a commitment to scope the current Allied Health Professional (AHP) vocational rehabilitation service provision for users of mental health and forensic mental health services. An AHP Consultant for Forensic Mental Health (Jean McQueen) and an AHP Lead for Mental Health (Lisa Greer) were recruited to a one year secondment to carry out this work. The overarching aim of this report (which focuses on forensic mental health) is to review current vocational rehabilitation provision by Allied Health Professionals in Scotland and produce national guidance on a way forward modernising practice in line with evidence and what Service Users tell us is important.

The report answers the following key questions:1) What is the current evidence for vocational rehabilitation in forensic mental health?2) What do forensic mental health Service Users view as important in their journey towards work?3) What do AHPs in forensic mental health contribute to vocational rehabilitation? 4) What are the barriers and challenges which influence effective vocational rehabilitation service delivery in forensic mental health?5) What are the implications for evidence based practice and further research identified during the course of this work?Key MessagesEngaging in a productive occupation can be fundamental to an individual’s health, well-being and self esteem with work having a fundamentally positive impact on both physical and psychological wellbeing providing both purpose and meaning to life. Through the data collected from service user participants, Allied Health Professionals (AHPs), and evidence from published research it is possible to support people with forensic mental health issues into mainstream employment. Positive outcomes are greatly enhanced through offering vocational rehabilitation early in the care process. The key principles in providing effective vocational rehabilitation support the use of client centred practice, partnership working with employability agencies and an emphasis on the aspiration to work at the earliest opportunity. The Service Users who contributed to this project are testament that clinical diagnosis and mental health symptoms are not a good predictor of employability; with attitude, the aspiration to work and strong multi-agency working is a much more reliable indicator for success. Service Users cited occupational therapists as the profession most likely to be involved in vocational rehabilitation.How this work was undertakenThis document focuses on better delivery of evidence based vocational rehabilitation, with enhanced outcomes for our Service Users. It is not about new resources but about using our existing resources in line with what the evidence tells us works. The information reported follows a systematic review of the literature together with individual interviews and focus groups held with those with forensic mental health issues. AHPs throughout Scotland contributed much to this document through four meetings of the national AHP forensic network (appendix 1) and via a consultation event held at the Beardmore Hotel, Glasgow in March 2011. A series of visits to a range of forensic mental health services throughout Scotland was undertaken together with an online scoping exercise investigating AHP practice nationally. Consultation with key professionals working within Forensic Mental Health was also undertaken such as service managers, doctors, nursing staff and vocational rehabilitation specialists. The information outlined in this report demonstrates that AHPs are uniquely skilled to take the lead and respond to the current drive to implement and improve vocational rehabilitation for people with forensic mental health issues. The outcomes and impact outlined in this report will serve to further inform AHPs contribution in this important area.Outcomes and ImpactStructure1. Each forensic mental health service should have a vocational rehabilitation pathway/employability pathway (Appendix 2) which will include collaborative working patterns with employability partners, voluntary organisations; charitable trusts and welfare benefit advice. 2. Vocational Rehabilitation leads with senior management support should be identified in all forensic multi-disciplinary teams to develop, deliver and monitor interventions offered.3. Vocational rehabilitation programmes should be based on the best available evidence (evidence based supported employment) and should involve working in collaboration with employability agencies.Process1. All forensic mental health Service Users should be asked about their aspirations towards paid employment early and throughout their rehabilitation. An individualised client centred vocational rehabilitation plan should be collaboratively written with those who identify work related goals as an important outcome, with short and long term goals identified. 2. Activity checklists should be routinely used to inform treatment programmes particularly for those whose goals are not work related. These should be graded through the use of occupational analysis and treatment programmes evaluated using standardised outcome measures. 3. All Service Users within forensic mental health should be made aware of the benefits of physical wellbeing, with a section of their care plan related to this. Side effects of medication should be monitored and where necessary adjustments made to accommodate work.

Original languageEnglish
PublisherForensic Network
Commissioning bodyScottish Government
Number of pages44
Publication statusPublished - 2011


  • mental health
  • forensic mental health
  • national guidance
  • vocational rehabilitation


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