Occupational Therapy in Mental Health: Crisis or Opportunity?

Abstract

For at least a decade, concern has been expressed about the status of occupational therapy in mental health. Increases in the number of new jobs and clinicians have not kept pace with growth in other practice areas. Although growing criticism of the practice of deinstitutionalization and an increased focus on cost-effectiveness have recently become major public policy trends in mental health practice, the psychological and nursing professions have responded creatively in order to expand their influence and practice. This paper relates changes in the delivery of mental health services to the systematic study of policy development and careful planning needed to help occupational therapy accomplish the same goals.

A Survey of Occupational Therapy Practitioners in Mental Health

“…(Meeson, 1998 a, b) From the literature it appeared that occupational therapists concentrated on four clinical areas dementia; work rehabilitation; community mental health and forensic psychiatry. (Craik, 1998) There has been concern in the USA about the position of occupational therapy in mental health, with declining numbers of therapists noted (Bonder, 1987, Kleinman 1992, Paul, 1996. In 1986, Barris and Kielhofner surveyed educators who suggested the major problems in mental health were deficiencies in role definition, unifying theory and research validating the profession.…”

Factors Affecting the Number of Students Engaged in Mental Health Fieldwork Education

“…For at least the last two decades, leaders in the profession have voiced concern regarding the decline in mental health occupational therapy practitioners (Bonder, 1987;Paul, 1996).…”

“…Researchers have attempted to identify factors that have contributed to the decline and have offered recommendations to enrich the psychosocial fieldwork experience, initiate student exposure to mental health occupational therapy practice, and increase the numbers of students participating in mental health fieldwork placements (Atwater & Davis, 1990;Barris & Keilhofner, 1986;Bonder, 1987;Dallis & Starnes, 2004;Ebb & Haimann, 1990;Kautzmann, 1995;Price, 1993). Steele-Smith and Armstrong (2001) suggested that mental health practitioners set up structured fieldwork education programs that emphasize self-directed learning with peers and opportunities for students to lead therapeutic patient groups.…”

“…Tekell (2009) reviewed numerous issues related to fieldwork in mental health including suggestions for enriched learning activities, steps for developing a fieldwork program, and supervisory strategies. Bonder (1987) advised mental health practitioners to lobby for increased community support of mental health occupational therapy services; whereas Dallas and Starnes (2004) proposed the participation of mental health practitioners in occupational therapy classes.…”

The impact on occupational therapists of the reorganisation of psychiatric care in Sweden

“…There are very few published stud ies in which professionals have been surveyed regarding the transition from institutional care to community treatment. The articles published have mainly focused on changed professional roles (Aiken, 1987;Bonder, 1987).…”