Mental health

An introduction to the role of OT in mental health

'We feel that occupational therapists play a big role in the process of recovery and have a role in kick-starting your mind into recovery and occupation. This involves helping us find our own pathway in life and helping us learn the skills that would allow us to look after ourselves.'
A service user, quoted in Recovering Ordinary Lives

Occupational therapists in mental health work with people with all types of mental distress including depression, anxiety, psychosis, bipolar disorder and personality disorders. They work with people of all ages from children to older adults and in all settings such as hospitals, community teams and specialist services. They value recovery and social inclusion, and we have produced a ten year strategy called Recovering Ordinary Lives - the strategy for occupational therapy in mental health services 2007-2017. BAOT/COT estimates that there are 7000 clinicians working in mental health services in the UK.

Occupational therapists in mental health emphasise the relationship between occupation, mental health and wellbeing

People have an intrinsic drive to be active that is expressed through activities that form the fabric of their everyday lives. Occupations include everything that people do in everyday life and are central to the existence of individuals, groups and communities. Occupation is the means by which people maintain themselves in the world and realise their potentials (COT 2006a, Wilcox 1998).

In the eyes of the world, people are largely what they do through the roles that they adopt in life

Maintaining an acceptable and personally satisfying routine of activities that have meaning and value for the individual creates a sense of purpose and direction to life. Conversely, any disruption to the individual’s daily routines caused by illness or disability can lead to dissatisfaction, disorientation and distress. Occupation is therefore essential for good mental health and well-being and this is reflected in occupational therapists increasingly working in mental health promotion, public health and community development (COT 2006b).

Occupational therapists understand mental health problems from a social model of disability and recognise the wider social issues that contribute to mental distress

Wider social issues which contribute to mental health problems include poverty, racism, sexism, homophobia, the hidden legacy of sexual, emotional and physical abuse, the impact of war, torture, displacement and other stressful life events.
 
Occupational therapists also recognise that many service users feel that they are experiencing 'sane' reactions to a sometimes hostile, uncaring and 'insane' society. With professional roots in social justice, occupational therapists believe that mental health problems should not just be formulated around the individual but should also be tackled at a societal, economic and political level (Hean Lim 2005).

Occupational therapists draw on their values and beliefs about empowerment, choice, independence and the importance of purposeful activity

Many of these values are shared with service users and other members of the multi-disciplinary team (DH 2004). Working together, all team members contribute to understanding a service user’s strengths, difficulties, physical, social and psychological health. 
 
Occupational therapists bring a unique and expert view of the service user’s full range of actions and activities.They work with service users and carers to develop and maintain a personally satisfying routine of everyday activities that creates a sense of purpose and direction to life. They will typically look at service users’ self-care, leisure and work activities and the individual’s hopes and aspirations.

Occupational therapists work with people with a wide variety of mental health difficulties in many different settings like hospitals, community facilities and in people’s own homes

Their main focus is to work out how a person’s daily activities and roles may have been contributing to their illness and how the right activity at the right level can be part of the person‘s social inclusion and recovery.
 
Occupational therapists will offer a range of therapeutic activities such as sports and creative arts. They may offer psycho-educational groups such anxiety management and back to work groups. 
 
They will also look at the environment around the person to see if they can make it as supportive as possible for the person. If someone has been in hospital, an occupational therapist may take the person on a trial trip home called a home visit. Occupational therapists also make recommendations about the type of accommodation a person may need to live in and packages of support.
 
Occupational therapists often embrace a wide role in mental health services and will sometimes also offer cognitive behavioural therapy or counselling and may act as care coordinators for those using the Care Programme Approach (DH 2007).

Service users tell us that independence, role retention, return to work and being active are important for them

Occupational therapists deliver all this because they are good at engaging service users while retaining contact with services. They do this by working with the person, alongside them, empowering them throughout the intervention.
 
Occupational therapists are also good at facilitating service user improvement so they are able to move on to other services or mainstream facilities. This is done by working with the person’s social, vocational and local community to ensure a receptive and supportive environment.

The occupational therapy training is based on the bio psychosocial model which equips occupational therapists to work with co-existing mental and physical mental health problems

Occupational therapists are therefore good at managing complexity and using their expert knowledge of activity analysis, synthesis, adaptation, grading and sequencing which speed the service user’s recovery.
 

References

 

Further reading and resources on OT and mental health

 

 

Occupational therapists provide cost effective solutions for mental health services

Occupational therapists work with service users to help them to regain and maintain a personally satisfying routine of everyday activities – this could include self care, leisure or work activities -  that they need or want to do, in order to help people experiencing mental health problems to live life their way.  By working in this way, occupational therapists can ensure service users choose health-enhancing activity and alter lifestyle habits such as smoking, diet and exercise.
 

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OT provides cost effective mental health services
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