The role, challenges, and impact of occupational therapists in custodial settings: A scoping review

The number people in custodial settings (i.e., jails and prisons) is increasing globally. In addition to detention and supervision, rehabilitation and skill development are often key goals of corrective services. The high care needs and vulnerability of detainees can often make this challenging, requiring input from a variety of health-care professionals, including occupational therapists. The aim of this scoping review was to synthesise the peer-reviewed literature regarding the role of occupational therapists in custodial settings, the challenges occupational therapists experience in custodial settings, and the impact of occupational therapy on outcomes for people in custody.

A scoping review guided by the Joanna Briggs Institute approach was undertaken. Three online databases (CINAHL, EMBASE, and the Criminal Justice Database [PROQUEST]) were searched from January 2013 to May 2024. Studies were included if the Population was occupational therapist(s), the Context was a custodial setting (jail/prison/correctional facility), and the Concept was the role of, challenges to, and the outcome/s of occupational therapy. The Mixed Methods Assessment Tool was used to appraise study quality.

There was no consumer or community involvement.

Eleven studies were included in this review; three mixed methods studies, one participatory research design, and one critical reflection, with the quality of evidence varying. The role of occupational therapists was primarily in providing direct care. Challenges experienced by occupational therapists were classified into four categories: (i) engagement, (ii) environmental, (iii) governance, and (iv) resourcing. Acts of violence and recidivism rates decreased in detainees who received occupational therapy.

Despite the often-restrictive nature of jails and prisons, occupational therapists working in custodial settings are in a unique position to develop and implement interventions that support detainees with developing life skills and improve post incarceration employment opportunities. This in turn is suggested to contribute to reduced recidivism.

People held in prisons and jails often have health and social care needs. Not meeting these needs can lead to housing and job problems after being released. Occupational therapists have an important job. Little is known about what occupational therapists do in custodial settings. This review sought to understand this. Findings showed that staff and detainees liked having occupational therapists. They helped with managing the detainees' feelings and reduce anger. They also helped detainees to get a job and housing after being released.