Featured job: IAPT Practitioner, The Forward Trust

We hear from Emma Coulson, Service Development Manager at The Forward Trust, about a new role in changing times…

Emma Coulson, Service Development Manager at The Forward Trust, tells me: 'These are really exciting opportunities. In April, we won the contract to run IAPT services in five new prisons: they are quite different, ranging from Category B to Category D. Some services will be built from scratch and some will be expanding existing provision; there are real opportunities to shape and extend them. We genuinely co-design services with front line staff and service users so this is a great opportunity to develop.’

Forward was founded in 1991 to support people in prison with drug problems. Its core services still address addictions but it has extended into areas such as employment. ‘We work in 21 prisons in total and also have two community and one residential service.’

Are you looking for people with experience of delivering IAPT in prisons? ‘That would be desirable but if we see the right candidate without that experience, we will offer training. In fact we are quite flexible about experience and where someone is in their career. The critical issue is someone’s personal qualities. To work in prisons you must be adaptable, flexible, passionate about clients and resilient. IAPT in prison environments is different from delivering it in the community.’ I asked Emma to amplify this point. ‘We have to adapt both client criteria and delivery methods. Many of our clients present with complex issues that would preclude them from community IAPT. And we do not have the communication infrastructure and opportunity to deliver services at a distance, so we have to innovate in how we deliver. Working in prisons is all about relationships. They are their own systems and you have to embed yourself in them, creating relationships with others: prison officers and secondary mental health teams for instance. Then there are specific issues you have to take into account: risk and security are two obvious examples.’

How do you support these roles? ‘A lot of our staff possess lived experience and are incredibly supportive. But we have a particularly good system in place. There is clinical weekly supervision, monthly clinical skills training and line manager and regional manager supervision. Every quarter there is a meeting to discuss training needs. Front line workers do train and develop into other roles in the organisation. We also provide staff with not only a health package and a salary matching NHS Agenda for Change pay scales, but a personal therapy allowance, which is unusual.’

The roles work in teams. ‘They mirror community teams and comprise Psychological Health and Wellbeing Practitioners and High Intensity Therapists, working very closely with the secondary mental health team.’

I suggested to Emma that she sounded hugely enthusiastic about these jobs. ‘I think you find you either love or hate working in prisons. I love it because I really enjoy the challenges it sets.’

Talking of challenges, Emma goes on to talk about the challenges of Covid-19:

‘We have had to adapt our ways of working due to limited access to our client group and social distancing. Staff have adjusted their working hours to reduce numbers in the office so that we are able to socially distance. We recognised that Covid-19 was having a real impact on the prisoners’ Mental Health as they were more anxious and their mood generally lower. We designed a self-help leaflet on how to keep safe and manage anxiety and self-isolation during Covid. The leaflet was given to every prisoner. We also recognised that prisoners coming up for release were extra anxious, as the world has changed… so we developed materials to support them explaining how things had changed and how they can access support. We noticed that prisoners were finding it hard to stay in touch with loved ones due to no visits, so we developed family packs so the men could write to their loved ones, children, make cards… we gave tips on how to write letters and engage with their children from afar.

Face-to-face contact had to stop for a while but we still maintained regular contact with our caseload delivering self-help material, in-cell activities and distraction packs to their cell door. Some cells have telephones installed so we were able to keep in touch with some people by phone, still completing assessments and sessions. Communication has been really important we are in regular contact with the men so that we can keep them updated and monitor their Mental Health. We are also in regular contact with officers to make sure that we are offering support to those that need it.

We are now starting to deliver face to face interventions in some of our prisons, but these are socially distanced sessions, the men are sent letters beforehand to prepare them so they know what to expect. If we can’t socially distance then staff wear PPE… again, we speak to the men before the session so they know what to expect and are not alarmed. The men complete part of the assessment in their cell before the session to avoid passing to much paper around.

In the future I think we will start to see a greater demand for our service. I think Mental Health is the hidden harm from Covid-19… it has triggered a lot of trauma and anxiety for people. We may have to continue to adapt our service to meet an increase in demand. I think we will make more use of telephone facilities at those prisons that have these facilities. The men have responded well to the distraction packs and family packs, so these interventions would be something we would consider keeping when things return to normal.’

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