Mental Health and Social Inclusion An OT Perspective

Mental Health and Social Inclusion: An OT Perspective By Reannen Ryles and Natalie Saunders

What is Occupational Therapy � Enabling satisfying and meaningful lives through occupations. � Occupation: the engagement or participation in recognizable everyday life endeavour. � Physical illness, injury or disability, mental illness and the process of aging can all impact on participation in everyday activities.

Occupational Therapy Continued � Assessment: ◦ ◦ ◦ Physical Cognitive Sensory Psychosocial Environments Motivation � Intervention ◦ ◦ Building skills and capacity Education Assistive equipment Modifying the environment

OT Perspective: P-E-O Model PERSON OCCUPATIONAL PERFORMANCE: the “doing of occupation” (Meriano & Latella, 2004) Values & beliefs Identity Roles & routines Skills & strengths Physical, cognitive & psychosocial status OCCUPATION ENVIRONMENT Self-care Productivity Leisure Rest/Sleep Physical Social Cultural Legislative Institutional

OT’s Role in a Community Mental Health Team � Assertiveness � Cognition � Independent living � Vocational interests and pursuits � Self-awareness � Interpersonal and social skills � Stress management � Activities of daily living � Role development � Self-sufficiency and interdependency � Wellness.

Similarities between OT & Graceville frameworks � Holistic � Person-centred - self identified goals - individual is expert in own life � Focus on strengths, not limitations � Focus on clients interests � Encouragement of independence – ‘tool box’

OT-specific Approach � Top-down approach to recovery � Occupation as means and goal of intervention Occupation Activity Task Performance Components

Barriers to Social Inclusion in the Community � Internal ◦ ◦ ◦ ◦ Motivation Patience Enthusiasm Anxiety Fear Self-control Perceived stigma Pain/ physical health/ vision ◦ Personality � External ◦ Access & Transport ◦ Finance ◦ Stigma ◦ Limited job vacancies ◦ Visitor policies ◦ Social/ family support ◦ Weather

Enablers of Social Inclusion � Internal o Insight o Motivation o Good self-esteem o Positive selfidentity o Impulse control o Spirituality o Coping skills � External o o o Access & transport Location of Graceville Public Trust Service cars Graceville support staff Graceville residents

Case Study: K. H. PERSON • Low motivation • Low self-control • Enjoys the transaction of $ • Fear & Anxiety • Diabetes OCCUPATION ENVIRONMENT • Op-shopping • Collecting • Looking after pets • Watching TV • Grocery shopping • Visiting mum • Location of G/V central • Restricted to Nambour • Graceville support • Limited family support • Stigma • Public Trust • Meals on Wheels

Approaches to Intervention: Remediation vs. Compensation � Remediation: ‘the act of treating a “condition” and allowing an individual to regain lost skills and function’ � Compensation: ‘provides opportunity for independent performance through adapting the task or introducing tools/equipment to the client’

O. T. Perspective: Recommendations for Social Inclusion � Education - Remediation & compensatory approaches - Mental health info night at church - Coping mechanisms

OT Perspective: Recommendations for Social Inclusion � Utilizing service cars to initially engage client in occupation where appropriate - Compensatory approach - Highlights use of OT top-down approach � Grading demands of activity - Remediation approach � Weekly planner - Compensatory approach

O. T. Perspective: Recommendations for future research � Motivational assessments � Motivation interventions and strategies � Reducing community stigma - advocating

References Atchison, B. , & Dirette, D. (2007). Conditions in Occupational Therapy: Effect on occupational performance. Ed 3 rd, Philadelphia. Lippincott Williams & Wilkins American Occupational Therapy Association. Retrieved from: http: // www. aota. org/Consumers/consumers/ Mental. Health/Community/35166. aspx Christiansen, C. H. , & Townsend, E. A. (2004). Introduction to occupation: The art and science of living. (2 nd ed. ). Upper Saddle River, New Jersey: Pearson. Duncan, A. (2006). Model of Human Occupation; Frames of Reference. In Foundations for practice in occupational therapy (4 th ed. ). (pp. 68 -105, 191 -26). Churchill, Livingstone: Elsevier. Meriano, C. , & Latella, D. (2008). Occupational therapy interventions: Function and occupations. Thorofare, NJ: SLACK Incorporated