Speak Out October 2020 DIGITAL EDITION FINAL

"I have become confident in being clear with what my minimum standards are for practice."

contact about an individual. The individual had been incarcerated on numerous occasions for ringing the emergency services and making bomb threats. However, this case manager was of the belief there were other factors in play. The most rewarding and fulfilling part of completing this assessment and increasing my passion and desire to work in justice and mental health was the outcomes of the assessment and involvement in the initial components of treatment team. The results of the assessment assisted the young man’s treatment team to understand that he has Autism and an associated severe language disorder. As they followed through with recommendations from the Speech Pathology Report he was also diagnosed with a moderate intellectual disability. He was using delayed echolalic phrases and ringing a service where he knew the phone would be answered. Working closely with the team he was supported to transition to supported living and provided strategies and skill development around communication and other skills. He has since stayed out of prison. More recently I was approached by a Barrister to engage in a communication assessment for a Supreme Court case, a murder trial. I felt a great sense of pressure, doubt and uncertainty. Thoughts that crossed my mind included, that this was a new area to promote the profession and the value speech pathologists can have, the pressure of being involved in a high profile case in the media and the doubt, if I could do it justice on all fronts. I was fortunate to have access to Mary Woodward, Senior Advisor for Mental Health and Justice at SPA to use as a sounding board. The forensic psychiatrist had requested a cognitive assessment and a language assessment. The psychiatrist had worked alongside speech pathologists when he was training and valued the input of speech pathologists in mental health. The young man in question was referenced as “odd” by prison officers, the barrister and the psychiatrist himself. There were concerns about his presentation. The psychiatrist requested the assessment to in order to make a decision on if the young man was fit to plea. It was an eye opening experience. The young man had three psychiatric assessments that each of the psychiatrists were not aware of. I was advised later that this is common practice till the defence find a provider who is able to support their cause. There were a range of observations by others on the young man’s presentation which included not responding or responding after

long delays and providing what appeared to others as incoherent responses. The speech pathology assessment results provided were given to both the psychiatrist and the lawyer who found it useful on his next visit. The lawyers were concerned that the young man was not able to instruct them on the required actions and follow the court case. My assessment highlighted that the young man had average language skills but significant delays with processing information varying from 40 seconds to 2 minutes. He would construct the sentence in his head and then talk. Even if the communication partner had moved on to another topic he was still responding to a previous topic. When information was written down and presented he was able to respond immediately. If he was provided with time and the opportunity to write information down this was easier for him than if he was required to provide information with no preparation. Ultimately this lead to the court case proceeding and the young man being sentenced. Even after all these years of practice it was a hard position to be in when the result of providing information that was requested led to a negative outcome for a young person. Being vulnerable and acknowledging these feelings and reflecting on each of my experiences as learning opportunities has been valuable. They have given me the strength and skills to support people in the mental health and justice system and promote the profession. I have become confident in being clear with what my minimum standards are for practice. These include having access to background information and any known triggers, a staff member who the person is comfortable either outside or within close vicinity, asking for the duress button as well as the exit plan if there is an incident or a code being called in any of the secure environments even before I see the person. When a referral for a language assessment is made I advise the referrer that my minimum standards are assessing literacy skills and high order skills such as reasoning, inferring and predicting and meeting with the care team at the end of the assessment. This has been the most valuable part of the assessment, to go through the report and provide strategies to implement in their current treatment. I hope my journey has provided you with both insight and inspiration to consider working in this sector.

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October 2020 | Speak Out