Reflection on developing Occupational Therapy in a

Psychiatric Intensive Care Unit.

Using John’s Model of Reflection

About PICUPICUs were developed in early 1970s

Closed Wards

Specialist environment

DH Mental Health Policy Implementation Guide on minimum standards published 2002

2012 Consultation Papers on low secure and PICI closed on 19th April 2012

Definition of PICU

Detained Patients in secure condition

Patients acutely disturbed

Associated loss of capacity for self control

Increased risk to safe therapeutic management in general acute ward.

Be of increased risk of vulnerability

Care and Treatment patient centred, intensive and multidisciplinary

.

Johns: Description of Experience

Describe the experience and what were the

significant factors?

Changes –

New Hospital

New OT Team

New way of working for the MDT

Induction of OT service to the PICU

Johns: Reflection

What was I trying to achieve and what are the consequences?

Understanding the need

Integrate and work with the MDT

Ensure Meaningful and Purposeful Activities for Service Users.

Developing activity based risk assessments

Consequences were the lesson learn and moving to flexibility of approach.

Johns: Influencing Factors

What things like Internal/ External/ Knowledge affected my decision

making.

OT staffing levels

Impact on OT department ‘Activity Street’

Engagement levels and techniques

Ward Expectations and changes

Patient experience

Risk

Johns: Could I Have dealt with it better?

What other choices did I have and what were the

consequences?

YES I had to make other choices.

I felt service users were not getting a good enough OT service.

OT assistants did not like going there.

Johns: Learning

What have I changed because of the

experience and how did I feel about the experience?

How has this experience changed my ways of

working?

Engagement techniques

Activities based on individual need and attendance to ‘Activity Street’

Developing the use of standardised assessments

OT is valued by MDT as they see outcomes and benefits.

References Johns Model of Reflection www.afpp.org.uk/filegrab/johnsmodelofreflection.doc?ref=45 accessed 18/5/12

Mental Health Policy Implementation Guide: National Minimal Standards for General Adult Services in Psychiatric Intensive Care and Low secure Environments Dept of Health. 2002

Psychiatric Intensive Care: Good Practice Commissioning Guide Consultation Dept of Health January 2012