For patients who choose to attend education groups significant gains in social functioning and quality of life are possible without specific skills training.
Scotland's mental health quality and outcomes framework has a clear focus on the intelligent use of information and targets. Developing and refining our approach in partnership with key stakeholders has enabled a culture of trust over the use of information. The service is willing to collect it, analyse its meaning and redesign clinical practice and services to improve performance.
Occupational therapists who have experience of working in multidisciplinary teams will be aware of the advantages and disadvantages. A frequent area of confusion and sometimes conflict lies in defining the role of the individual disciplines. This article looks at the history and the philosophy of occupational therapy and discusses the skills contributed by the occupational therapist working within a multidisciplinary team in mental health. It divides the skills of the occupational therapist into: practices restricted to occupational therapists; those expected of occupational therapists; those shared with other disciplines; and specialist skills acquired through individual interest and enthusiasm. The authors hope that it will encourage occupational therapists working in multidisciplinary teams to define more clearly, and with greater confidence, their skills in their areas of work.
The responsibility the health service owes to relatives who care for mentally ill patients is gradually being acknowledged. The Griffiths Report (1988) makes explicit both that families should care for their ill members and that the health service has a duty to provide some support. The new support for the family is more to enable them to be ‘better carers’ and to cope with the burdens of caring. One area of psychiatry where this support is a growth area is for relatives of people with schizophrenia. Research points to both the impact of some families on the career of the patient, including relapse rates, and the ways in which such negative impact can be reduced (Leff et al, 1989). This paper is concerned with the ethical issues involved in offering a service to relatives. The ethical dilemma of access to relatives is intimately related to the person at whom outcome is aimed.
From the plethora of articles examining the role of individual disciplines within the community mental health team, one discipline appears almost conspicious by its absence. How has occupational therapy become the forgotten speciality?
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