As part of the College of Occupational Therapists' Mental Health Project, a survey of occupational therapists practising in mental health in the United Kingdom was conducted. A questionnaire was sent to 200 members of the Association of Occupational Therapists in Mental Health and achieved a 68.5% response rate. The majority of the 137 respondents were female, with Senior I staff between 20 and 30 years of age, who were unlikely to have worked in another area, forming the largest group. Although most had received additional training, they identified the need for more training, especially in aspects of occupational therapy. Most were managed by an occupational therapist and 96% received supervision. Community mental health was the most frequently reported area of work, with leisure, counselling, anxiety management and creative activities the most frequently used interventions. The respondents were committed to the core principles of occupational therapy and the need to develop outcome measures and evidence-based practice, and were concerned about moves to generic working. This study has provided data not only for the position paper on the way ahead for occupational therapy in mental health but also for individual occupational therapists and managers.

The future of occupational therapy in mental health has been a topic of reflection and debate. The Education and Research Board (now the Education and Practice Board) of the College of Occupational Therapists created a Working Group to develop a position paper on the way ahead for research, education and practice in mental health.Following consultation, the Working Group reviewed literature, examined current research and surveyed practitioners, managers and educators. From these findings, recommendations have been made which will lead to a firmer evidence base for the practice of occupational therapy in mental health, leading to a more effective use of the expertise of occupational therapists and an improved service for users.

Occupational therapists work in various specialisms within the field of mental health. Forensic psychiatry is one which is rapidly developing. Any occupational therapist wishing to work in this specialism would probably wish to know what they were ‘in for’. Media images of mentally ill criminals have shaped public attitudes and have hidden the realities about how interesting forensic psychiatric work can be.

This paper briefly outlines the role of occupational therapy in assessing and treating patients with the tripartite problems of mental disorder, dangerousness and an addictive behaviour. The first unit dedicated to the management of such patients within conditions of high security was opened in Broadmoor Hospital in 1995. It is a 25-bedded male inpatient ward. This article focuses on occupational therapy in this unit, the forensic addictive behaviours unit, but many of the issues discussed apply to patients with an addiction within other forensic psychiatric settings.

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