Speak Out October 2020 DIGITAL EDITION FINAL

Feature

Speech pathologists working in the Mental Health and Justice Sector are a vital part of the assessment and care team. This is a growing area in our profession. I am hoping that my journey provides some insight to others who are thinking about working in this sector. I have been working as a speech pathologist over twenty years. Over the past fifteen years I have been involved in both the assessment and treatment of individuals involved in the mental health and justice system. People often wonder about the role of a speech pathologist in this sector. I attempt to describe my experiences and thoughts in the section below to provide the reader with some insight. It can be confrontational entering a custodial environment. You need to disclose personal information by listing and signing your name on a document that is visible to everyone. There are body searches, finger printing and eye scans. More recently I have been requested to remove my shoes and enter closed security doors and have a gust of air blown on me (drug identification). It can be confronting at an emotional level seeing people pacing back and forth in a small space, hearing people calling out in distress, being placed in units that are small and confined and being told you need to do the session with an individual on your own, which leaves you feeling vulnerable in the situation. The security clearance takes days and even though all the minimum requirements were articulated to security previously communication within these settings are not always effective in reality. On most occasions I have proceeded with the assessments. Reading background information can also be challenging. However, it is vital that one has access to developmental history, medical information and previous assessments as these factors have an impact on language and communication. Trauma, medication, and mental health have a significant impact on a person’s ability to communicate. Reading Member perspective Working in mental health and justice By Enaksha Garde

court reports and diagnostic reports can also be emotionally confronting. Over the years I have had numerous internal dialogues checking in with myself; am I carrying traumatic information with me, is it impacting on my daily functioning, is it affecting my wellbeing and sleep patterns. I have had internal discussions with myself about my role and being very clear about it. I have come to the conclusion that in the assessment and treatment sessions my role is to support the care teams to better understand and support this person to achieve better outcomes. The person’s behaviour or history they have experienced should not impact on my perception of them. I constantly analyse myself to ensure that the information I present is objective. Over the years it has been my experience in the justice and mental health sector that a speech pathologist is engaged because someone on the team has had experience working with a speech pathologist or as a last resort when the team reports that treatment is not working. On all of these occasions there has been a language disorder and/or reading difficulties or a dual disability that have not been previously noted. The outcomes of the assessment have significantly impacted on treatment including how the clinicians communicate and present information and develop strategies. It is of essence that as speech pathologists the assessment results are interpreted and reported back in the context of the treatment or practice of the care team. Going through the results themselves in these contexts does not always translate to a change in practice. For example being specific and stating that the person requires explicit teaching of the problem solving framework or as the person does not understand concepts of time and recommending the use of visuals to support their understanding of the sequence of events when teaching a new skill. An early career example of such practice was when a case manager I had previously worked with made

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Speak Out | October 2020