New Directions in Working with Complex and Challenging Behaviours in Prison: The Moroka Program

Simsion D¹, Kam R¹, Fougere A¹

¹Forensicare

Biography:

Dr Daniel Simsion, Dr Rebecca Kam, and Dr Amber Fougere are psychologists in Forensicare’s Moroka program, a program in Victoria’s prison system for individuals with complex and challenging behaviours related to mental illness, particularly personality disorder.

Across prison services, a high-risk group of individuals with personality disorders present with particularly severe and entrenched patterns of suicide, self-harm, violence, and other challenging behaviours. For this complex subset of prisoners, these behaviours are highly disruptive and challenging, posing significant difficulties for custodial services. Such individuals can exhaust a large amount of resources, often leading to system responses that are restrictive. These interventions tend to focus on short-term risk management, limiting the ability to support longer-term person-centred recovery and rehabilitative prospects.

This talk will discuss the recently reviewed and revised Moroka program, a specialist program run by Forensicare, delivered across all Victorian prisons. This program is designed to provide treatment to individuals with a personality disorder engaging in complex and challenging behaviours, as well as system-wide support to promote evidence-based effective management and intervention. In 2020, the Moroka program was paused, and the unit repurposed in relation to the COVID-19 pandemic. This break allowed for a comprehensive review and updating of the program. This talk will discuss the experiences of this process, as well as the program’s re-implementation. This will include a focus on:

• Learnings from the first iteration of the Moroka program.
• The application of Dialectical Behaviour Therapy (DBT) principles by custodial and multidisciplinary mental health staff
• The implementation of the updated program, using both an inpatient and outreach model.
• The multi-stakeholder systems level approach employed, including engagement of senior correctional staff, forensic intervention services and health services, to support best-practice intervention and management of complex behaviours.
• Implications for best-practice when managing challenging behaviours in custodial setting.