Australian Occupational Therapy Journal (2014) 61, 213–214
2020 Vision: Promoting participation, mental health and wellbeing through occupational therapy – What are we doing and where are we heading? The power of engagement in everyday activities to restore and maintain mental health and wellbeing is a crucial dynamic of occupational therapy, recognised since its inception. Working with people experiencing mental ill-health to improve their lives and wellbeing has long been a specific practice area within occupational therapy; it is also one that is rapidly changing with the emergence of evidence-based practices in areas such as employment, relapse prevention and self-management, as well as service reform to implement recovery-promoting practices. Psycho-social factors are also an important consideration in occupational therapists’ work to address difficulties in occupational engagement and performance faced by people with diverse health conditions, as well as those who experience disability and changed life circumstances, such as homelessness, migration, unemployment and retirement. Therefore, this Special Issue offers an exciting opportunity to consider the scope of occupational therapy research, education and practice in relation to the restoration and maintenance of mental health and wellbeing. Looking back over the seven years since the last special issue of the Australian Occupational Therapy Journal devoted to mental health (Volume 54, Issue 1), more than 50 articles and critically appraised papers related to occupational therapy in mental health have been published in the journal. Here, we illustrate the developing range of evidence to support occupational therapy practices, either addressing occupational engagement and performance issues in populations with mental ill-health or promoting participation and mental health, published over this period. One important issue is to develop and test occupationally based interventions. Promising results are reported in two recently published intervention studies: one is a play based intervention to support optimal social development in children with ADHD (Wilkes-Gillan, Bundy, Cordier & Lincoln, 2014) and another focuses supporting individuals to reflect on their occupational narratives and develop a vision for their occupational future (Gunnarsson & Bj€ orklund, 2013). Other studies have explored supports for individuals living with mental illness to engage in education and
© 2014 Occupational Therapy Australia
employment; demonstrated positive effects on return to work among women with stress-related disorders through an intervention focussed on Redesigning Daily Occupations (Eklund, W€ astberg & Erlandsson, 2013); and reported the positive outcomes achieved by adolescents accessing occupational therapy services through the Better Access to Mental Health Initiative in Australia (Kohn, Hitch & Stagnitti, 2012). The development and validation of assessment tools has been the topic of several research reports focussed on methods to evaluate satisfaction with one’s daily occupations, social participation, and the influence of information processing on occupational performance. Such tools are important not only to enable exploration of important occupational issues in practice but also to measure occupational therapy outcomes. Occupational experiences of a variety of populations have been explored, including: the play preferences of children with and without ADHD (in both Australia and Brazil); occupational engagement of young adults and adults living with mental illness, both in community, inpatient and forensic settings; and the exploration of meaning gained through participation in a community-based football club for socially marginalised individuals; and the time use of unemployed youth. More recently, a qualitative study explored the complex range of support-based occupations used by parents of young people with mental illness to support their optimal health and wellbeing (Honey, Alchin & Hancock, 2014). Other papers have tackled topics of increasing importance to occupational therapy and mental health services more generally: obesity and diet-related interventions (Haracz, Ryan, Hazelton & James, 2013); programmes for homeless adults, refugees and other populations at risk of social exclusion; and the issues of consumer engagement in research (Hancock, Bundy, Tamsett & McMahon, 2012). AOTJ has also published a variety of studies exploring workforce issues for occupational therapists in mental health. These have investigated issues such as: factors related to recruitment and retention; burnout and work engagement; occupational therapy roles and multidisciplinary team communication; factors related to the prioritisation of referrals; and discussions of the advantages and disadvantages of discipline-specific and “generic” work roles. One of the most recent among
214 these papers reports research by Ashby, Ryan, Gray and James (2013) exploring factors associated with professional resilience among occupational therapists working in mental health, a critical issue to understand for ensuring the sustainability of an occupational therapy workforce in the mental health field. Reflecting on this body of knowledge, there are some evident gaps. Notably, many countries face ageing populations, and sustained participation in occupations is crucial to preventing social isolation and maintaining wellbeing in older adulthood. Yet, there have been relatively few published, at least within the Australian Occupational Therapy Journal, over the past 7 years concerning the contributions that occupational therapy can and should be making in promoting older adults’ participation, mental health and wellbeing. A recent summary (Clemson & Laver, 2014) highlights the powerful contribution that occupational therapists could make in this area, should we choose to take up this challenge. Looking towards the future, there are other exciting developments in occupational therapy and the mental health field, about which we would hope to see more publications in the near future. These include the implementation of recovery-oriented approaches in practice; the development of occupationally focussed interventions across diverse practice settings, such as primary mental health-care, schools, tertiary education, and forensic mental health settings; and the active engagement of consumers, families and carers as real partners not only in research, but also in education and these service developments. To support the achievement of this vision, if you are undertaking research, education, or practice development and evaluation with a focus on promoting or restoring mental health and wellbeing through participation in occupations of everyday life, put your pens to paper or fingers on keyboard and start writing.
Ellie Fossey1 & Justin Newton Scanlan2 Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia, 2Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia E-mail: [email protected]
© 2014 Occupational Therapy Australia
References Ashby, S. E., Ryan, S., Gray, M. & James, C. (2013). Factors that influence the professional resilience of occupational therapists in mental health practice. Australian Occupational Therapy Journal, 60, 110–119. Clemson, L. M. & Laver, K. E. (2014). Active ageing and occupational therapy align. Australian Occupational Therapy Journal, 61, 204–207. Eklund, M., W€ astberg, B. A. & Erlandsson, L.-K. (2013). Work outcomes and their predictors in the Redesigning Daily Occupations (ReDO) rehabilitation programme for women with stress-related disorders. Australian Occupational Therapy Journal, 60, 85–92. Gunnarsson, A. B. & Bj€ orklund, A. (2013). Sustainable enhancement in clients who perceive the Tree Theme Methodâ as a positive intervention in psychosocial occupational therapy. Australian Occupational Therapy Journal, 60, 154–160. Hancock, N., Bundy, A., Tamsett, S. & McMahon, M. (2012). Participation of mental health consumers in research: Training addressed and reliability assessed. Australian Occupational Therapy Journal, 59, 218–224. Haracz, K., Ryan, S., Hazelton, M. & James, C. (2013). Occupational therapy and obesity: An integrative literature review. Australian Occupational Therapy Journal, 60, 356–365. Honey, A., Alchin, S. & Hancock, N. (2014). Promoting mental health and wellbeing for a young person with a mental illness: Parent occupations. Australian Occupational Therapy Journal, 61, 194–203. Kohn, M., Hitch, D. & Stagnitti, K. (2012). Better Access to Mental Health program: Influence of mental health occupational therapy. Australian Occupational Therapy Journal, 59, 437–444. Wilkes-Gillan, S., Bundy, A., Cordier, R. & Lincoln, M. (2014). Eighteen-month follow-up of a play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder. Australian Occupational Therapy Journal, n/a–n/a. doi:10.1111/1440-1630. 12124.