Mental Health is an area of OT that I am super passionate about and so I LOVE the fact that we get the opportunity in fieldwork to #GoBeOT in this setting. If you read my post about my program, you know that our Level 1 Fieldworks are three weeks long, full time, providing interventions and engaging with our clients. Myself and three other classmates were in one group home setting, and a few of our other classmates were in a separate group home setting.
The site overall consisted of a two tier setup:
Independent Living
For individuals with severe and persistent mental illness that are able to safely function in community apartments with their own room, kitchenette, etc. There is a psychologist on site here 24-7 in addition to aides that assist with client needs.
Group Home
For individuals with severe and persistent mental illness that require additional assistance for ADL/IADL tasks. Clients in this setting have a roommate, roles & responsibilities assigned to them for to maintain the group home, a shared living space, share kitchen, etc.
If any individual required more in-depth care, or they were unable to take their medication independently, then there were skilled nursing facilities that this site was partnered with for their care.
The Group Home
At our site there were 14 residents, many of who were in their late 50/60’s, who were considered to be of low functioning and had a variety of disorders such as:
Mood disorders (major depression, bipolar disorder, anxiety)
Schizophrenia Spectrum and Psychotic Disorders (paranoid, childhood, schizoaffective, catatonic, disorganized)
Dissociative Disorders
Substance Use Disorders
In addition to these, there were many co-morbid diagnoses such a hyper/hypotension, diabetes (Type I and II), liver disease, kidney disease, etc.
The Value of OT in Mental Health
As OTs our focus is on the occupational performance of the individual and how to enhance quality of life and life satisfaction that are vital to overall well-being. A study by Castelejn & Graham (2012) reveals that the most importance factors in mental health intervention are:
Process Skills
Motivation
Communication and interaction skills
Self-esteem
Balanced Lifestyle
Affect
Life skills and role performance
Our Family Tree
For many of our clients, the day consisted of waking up, smoking, sitting around the house, eating lunch, smoking, watching TV, eating dinner (made by the tech) and going to bed. Additionally, we noticed that there wasn’t much interaction between the residents – everyone kept to themselves or at most, would ask someone for a cigarette.
Since this is a HOME, my classmates and I decided that we wanted to focus on promoting social interaction, roles and community. One of the first things we did was arts and crafts to bring some color to the room; it also allowed the residents to CREATE something that was uniquely theirs – it also opened the opportunity for conversations between the residents. We made a tree that was placed in the dining room where each resident wrote their name on a leaf and drew/wrote about the things that they like. Pretty soon we had our own Family Tree that represented the uniqueness of each of the individuals that lived there.
Roles, Routines, Responsibilities
My classmates and I focused on the context of meal time and in what ways we could hep promote engagement and delegation of tasks. Residents typically ate by themselves at different tables or outdoors, so the first thing we did was combine all of the tables into one long farmhouse table for everyone to sit at. From there we facilitated family dynamics, each week some residents were responsible for creating the meal, while others had the role of serving food, setting the table, pouring drinks, cleaning up, etc. We additionally had residents help us plan community outings to parks or to play basketball.
That applies to our clients as well.
With so many stigmas out there, we need to see people as PEOPLE. Humans with goals, ambitions, and roles that they want to partake in. This rotation showed me SO many ways that OT can have a pivotal role in mental health/community interventions – I could probably write a book on it! For now, I leave you with this brief snapshot of our experience.
Have you experienced the role of OT in mental health? Feel free to share your experiences in the comments!
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