Access to OT in the Prison System: Assessing Attitudes of OT Students and Practitioners

Prison reform is a focused initiative throughout the country at this time and with this, there will be an increased need for mental health and related services both in the prison setting and in the community to assist with the successful reintegration of this population. Although there are occupational therapists working in the criminal justice setting in this country, the need to expand our role in this practice area is significant¹. Understanding the attitudes and factors associated with the willingness to work in this area will help to inform those attempting to develop strategies to advocate for occupational therapy in this setting. Two studies, one with occupational therapy students² and one with occupational therapy practitioners³, were conducted to begin exploring this topic. The student study focused on the attitudes towards rehabilitating this population and the study with practitioners focused on factors associated with consideration of working in prison settings studies. Both studies were conducted in the state of Alabama, but the research approach and results are relevant to continue similar studies on a larger scale.

PURPOSE: The student study attempted to examine occupational therapy students’ attitudes toward rehabilitating inmates and the practitioner study explored the consideration of occupational therapists to work in prison settings, identifying the factors associated with their responses.

METHODS: The first study included 128 (of 151 surveyed) occupational therapy students from an Alabama university, using the Rehabilitation Orientation Scale via online survey, to explore their attitudes toward rehabilitating inmates. The second study included 172 occupational therapists in Alabama (of 1359 surveyed), using an online survey to explore factors associated with their consideration of working in prison settings.

RESULTS: The student study had a response rate of 84.8% (128/151) and revealed that 60% of respondents reported supportive attitudes toward rehabilitating inmates. Female students reported a more supportive attitude than males. Multiple regression analysis indicated respondents’ consideration of working in prison settings and their feeling that occupational therapy has a role in prison settings were significantly associated with support for rehabilitating inmates after controlling for gender and knowing someone who has been incarcerated. The practitioner study had a response rate of 12.7% (172/1359) and found that the consideration of occupational therapists working in prison settings was significantly associated with (1) having an exposure to a therapist working in the prison setting, (2) support for rehabilitating inmates, (3) the perception occupational therapy has a role in prison settings, and (4) knowing someone who has been incarcerated.

CONCLUSION: The majority of students reported supportive attitudes toward rehabilitating inmates, which is encouraging in terms of attempting to recruit new graduates to work with the inmate population. These students had some education about this topic embedded in their curriculum prior to the study. The findings of the practitioner study provide direction to develop strategies to increase occupational therapists’ likelihood to consider working in prisons. It seems that education and exposure are two integral components to improve the number of occupational therapists meeting the needs of this population. These studies could be expanded to include students and practitioners nationwide, which could give even more guidance as to how to effectively increase the number of occupational therapists working in this setting.

References

1. Munoz JP, Moreton EM, Sitterly AM. (2016). The scope of practice of occupational therapy in U.S. criminal justice settings. Occupational Therapy International, 23(3):241-54. DOI: 10.1002/oti.1427

2. Tucker, S. C., & Yuen, H. K. (2019). Attitudes toward rehabilitating inmates among occupational therapy students in the United States. Journal of Educational Evaluation for Health Professions, 16(6). doi: 10.3352/jeehp.2019.16.6

3. Tucker, S. C., & Yuen, H.K. (2020). Occupational therapists’ rehabilitation orientation toward people who are incarcerated. Journal of Correctional Health Care, 26(4). Anticipated publish date October, 2020.