As part of the College of Occupational Therapists' Mental Health Project, a survey of occupational therapists practising in mental health in the United Kingdom was conducted. A questionnaire was sent to 200 members of the Association of Occupational Therapists in Mental Health and achieved a 68.5% response rate. The majority of the 137 respondents were female, with Senior I staff between 20 and 30 years of age, who were unlikely to have worked in another area, forming the largest group. Although most had received additional training, they identified the need for more training, especially in aspects of occupational therapy. Most were managed by an occupational therapist and 96% received supervision. Community mental health was the most frequently reported area of work, with leisure, counselling, anxiety management and creative activities the most frequently used interventions. The respondents were committed to the core principles of occupational therapy and the need to develop outcome measures and evidence-based practice, and were concerned about moves to generic working. This study has provided data not only for the position paper on the way ahead for occupational therapy in mental health but also for individual occupational therapists and managers.

the findings suggest that the current model of pre-discharge home visits does not promote health and well being. For some older adults the home visit provoked anxiety, however home visits are important to carers.

Occupational therapy could overcome occupational alienation experienced by mental health day service clients, through the development of services within and beyond day services which promote a sense of belonging and offers meaningful occupation.

Institutional barriers could be overcome with a dynamic balance between risk management and mental health promotion through occupation. This demands a sustained focus on occupation for everyone involved in providing care and treatment in these settings.

This study, part of the College of Occupational Therapists' Mental Health Project, surveyed occupational therapy managers in mental health to gather data about them. the services they managed and their opinions on current and future issues of importance. A questionnaire was sent to the 184 managers who it was believed worked in mental health and it achieved a 65.2% response rate.The majority of the 120 respondents were female. with Head II therapists between the ages of 31 and 40 forming the largest group. Two-thirds had additional qualifications and 71 % had worked in mental health for more than 11 years. In addition to managing occupational therapy services, 86% carried a caseload or managed other services. Aspects of professional management were ranked highest in a list of tasks undertaken. Contradictions were noted in the managers' opinions on recruitment and retention of staff and the importance of staff supervision. The managers displayed commitment to the principles and philosophy of occupational therapy and a determination to demonstrate its effectiveness through research and evidence-based practice.This study contributed to the position paper on the way ahead for occupational therapy in mental health (Craik et a11998a) and provided information for occupational therapy managers to assist them to review their role.

Engagement in occupation is proposed to enhance health and wellbeing. To date, few studies have demonstrated this in relation to people with mental health problems. This study aimed to evaluate occupational therapy's beliefs in the restorative powers of occupation from the perspective of people with enduring mental health problems living in the community. Qualitative research methods were used in two mental health day service settings: a workshop, where woodwork was provided as a medium for creative therapy, and a drop-in facility. Participant observation was undertaken over 10 sessions and, during six in-depth interviews, the clients were asked about their occupational experiences and whether they had perceived any benefits from engagement in occupation. Content and inductive analysis as well as concept mapping of the data resulted in emergent themes and subthemes. Occupation was identified both as a means for building competence through the acquisition of skills, coping with challenges and achieving success and as a medium for developing self-identity through the drive to create, feelings of usefulness and engendering a sense of self. These themes help to support the need for an increase in the provision of meaningful occupation for people with enduring mental health problems. However, further research is required to develop and corroborate the findings.

With the emergence of occupational science, there has been renewed interest in the health benefits of occupational engagement and a call for more research into the occupational nature of humans. Engaging in occupations is known to have a positive effect on an individual's health and sense of wellbeing. A common feature of people with schizophrenia, however, is a decrease in volition and a reduction in the occupations performed. This study explored some of the influences on occupational engagement for people with schizophrenia living in the community. A qualitative approach was chosen, using semi-structured interviews. Four male and four female participants, aged 23 to 49 years, described the influences on their occupational engagement. Content analysis, primarily using coding and memoing, was employed to categorise the data. Four main themes emerged: health, routine, external factors and internal factors. Some specific factors identified within these themes were medication, daily schedules, staff, family, work, self-concept and challenges. The implications of the results are discussed, with particular reference to assisting occupational therapists to enable clients with schizophrenia to engage more successfully in occupations.

Journal of Clinical Nursing 15, 1418-1425Multidisciplinary perceptions of the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care Aim. This paper describes the perceptions of nurses, healthcare assistants, doctors and therapists of rehabilitation and the role of nurses and healthcare assistants on an acute older adults ward in a London teaching hospital. Background. The role perception, education and training and attitudes towards the older adults have been identified as barriers that have an impact upon the nurses' role within rehabilitation. However, little is known about the role of nurses and healthcare assistants in rehabilitation of older adults in acute health care. Design. Action research study. Method. Twenty-four semi-structured interviews were conducted and audio recorded about healthcare professionals' understanding of rehabilitation, the type of skills needed and their perceptions of the role of nurses and healthcare assistants in rehabilitation. The interview transcripts were analysed using the thematic content analysis. Results. The findings suggest that the therapists relied on nurses and healthcare assistants for therapy carry-over. Healthcare assistants were perceived as the professional group who could deliver therapy carry-over. There was an evidence of role hierarchy as healthcare assistants perceived that they were not actively involved in decision-making or discharge planning. Conclusion. This paper suggests that healthcare assistants and nurses are viewed as the professional group best placed to deliver therapy carry-over. However, whilst there is an acknowledgement of their role, there remains a reluctance to acknowledge healthcare assistants as a professional group and to involve them within decision-making and discharge planning Relevance to clinical practice. Employers must be seen to advocate, support and implement education and training programs for healthcare assistants. However, 1418Ó 2006 Blackwell Publishing Ltd whilst nurses and healthcare assistants have an integral role in rehabilitation, there needs to be more research into the how they are supported by therapy professionals.