Speech and Language Therapy in Prison
Hello! My name is Katie Hughes and I’m a Speech and Language Therapist working for an NHS Health and Justice Service in the North East of England. I graduated with a postgraduate degree in Speech and Language Therapy from City University London. I began my career as an SLT assistant in a national Medium secure adolescent forensic unit. I then continued my forensic journey to work with adults with mental health, Autism and Learning Disabilities in a forensic hospital, before ending up in my current role. I work part-time in Hartlepool Youth Justice Service (or 'Youth Offending') and part-time in a regional acute mental health wing based in HMP Durham.
It looks like I’ll be the first SLT blog on here which is interesting considering I work in an area that you may not associate with SLT. Let’s be honest, when people hear SLT they think stammering, speech, stroke… not prison! I left university with no clear route or client group I wanted to work with and fell into my role in forensics by opportunity. When I graduated there was very little (if any) mention of the SLT role in mental health and criminal justice settings.
I remember my first few months working in a prison very well. It was daunting and very alien for myself but others also. I remember getting more than a few odd looks from staff and patients alike when I was introducing myself…“Hey! I’m Katie, I’m a Speech and Language Therapist… Yes I work here!”. Our SLT Health and Justice Team launched as a brand new service in 2018 with a grand total of… two prison SLTs! Whenever I describe the first few years, the term “winging it” comes up frequently but we must have done something right as we’re now an established team in the Trust and have tripled in staff numbers covering a wide range of criminal justice settings.
A huge part of my role in the early days centred around building relationships with staff and establishing myself into the team and essentially, proving my worth! I knew that we, as SLTs, have an essential role in prisons but we needed everyone else to know that.
All sorts of statistics and numbers get chucked around in terms of estimating the percentage of people in prison with communication needs. They seem to range from 60-80% so in a nutshell, very high! This may surprise you, it certainly did for me, but when you dig beneath the surface and look at the individual's life as a whole, it all becomes a little clearer. Often we find many of our patients have experienced childhood trauma, abuse, difficulties accessing education due to unmet learning needs, this often then leads to mental health needs, feelings of isolation, difficulties connecting with others, vulnerability, difficulties managing and expressing emotions appropriately, leaving education with no qualifications, difficulties accessing employment, leading to a path of substance misuse and ultimately entering the criminal justice system. So many end up trapped in this cycle and this is particularly the case for those individuals with communication needs. It can be near impossible to access and understand vital things such as offending behaviour treatment courses, mental health interventions, licence conditions, court and education.
With that in mind then, where do I fit in and what does my role look like? I work within a regional specialist mental health unit based in HMP Durham. We have patients transferred to us from prisons across the North East for a period of assessment and treatment as a means of combatting the mental health crisis within prisons and the rising waiting lists for hospital.
My everyday role includes:
• Assessing for any communication difficulties and making functional recommendations
• Providing patient focussed therapy around any communication needs. This includes 1:1 and group work (would you believe I ran a Lego therapy group in prison? And it was a success!)
• Lots of joint working with nurses, support workers, prison officers, prison staff, psychiatrists, drug and alcohol teams, offender management, occupational therapy, community mental health teams, hospital teams… the list can and could go on! This is key to support our patients to access treatment in a way that is personalised and suitable to them e.g. education courses, offender treatment programmes, drug and alcohol recovery work, mental health interventions
The role requires lots of compassion, creativity, flexibility and curiosity – no day is the same and every day I learn something new!