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Introduction: The use of horticulture in mental health settings is widespread. Moreover, its effectiveness is supported by a body of qualitative evidence. Aims: The investigators in this research study sought to determine those aspects of their horticultural projects that conferred the greatest therapeutic benefit to their clients. They used outcome measures to rate the responses of participants, paying particular attention to the participants' expressed motivation. Method: Qualitative and quantitative methods were used to evaluate six horticultural projects. Ten participants were interviewed, using an adapted version of the Work Environment Impact Scale (WEIS) to rate factors that supported their motivation. Fifty participants were assessed, using the Volitional Questionnaire (VQ) to observe and rate the extent of their motivation. Findings: The therapeutic value of horticulture arose from a complex interplay of personal factors, including gender-based preferences, individual interests and social needs. Conclusion: The benefits of engaging in horticultural activity are not automatic. The external environment provides challenges, which can be graded by the facilitators to maximise the therapeutic benefit.

The Model of Human Occupation Screening Tool (MOHOST) plays a key role in the occupational therapy assessment protocol at an acute psychiatric unit in Britain. This paper incorporates a case study and discussions with the occupational therapists to explore how the assessment influences practice from initial assessment to final outcome measure and how single observation forms and prototype self-assessment forms based on the MOHOST have contributed to the assessment process.

This study examined therapists' perceived impact of using an occupation-focused model in mental health practice. The findings of this study provided promising results. Findings suggest that the utilization of MOHO increases service for clients and professional stature and identity for therapists.

A service-wide audit was conducted (audit 1, 2002) to ascertain the balance of occupation-focused versus generic tasks being undertaken by occupational therapists. This identified that 66% of all tasks were occupation focused, whereas only 41% of all assessments could be described as such. Recommendations were pursued to implement occupation-focused assessments. Audit 2 (2005) showed that the majority of assessments were occupation focused (61%), and audits 3 (2006) and 4 (2007) indicated that this increase was maintained. Audit 4 also demonstrated the negative impact of care coordination duties on an occupational therapist's ability to complete occupation-focused assessments.

Continuing professional development requires robust support mechanisms to maximise opportunities for the dissemination of best practice and to ensure sustainability. Accordingly, occupational therapists in a county-wide mental health service created a practice development adviser post and embarked on an academic partnership to support the delivery of evidence-based practice. Professional development surveys were then undertaken in 2005 and 2007 to evaluate the changes to the work environment. These demonstrated that the perceived pressures on standards of work (for example, finite resources and generic role demands) were offset by professional supervision, contact with other occupational therapists and having an occupation-focused model of practice.

The value of therapists documenting their clinical reasoning and negotiating specific and measurable goals is widely acknowledged. However, the literature suggests that practitioners often encounter barriers when implementing best practice. This article details how occupational therapists in Derbyshire Healthcare NHS Foundation Trust entered an academic partnership, which transformed their communication of clinical and professional reasoning. Having adopted a conceptual model of practice, they established clearly defined processes for assessment, case formulation and goal setting. Service users, carers and team members confirmed that these initiatives enhanced person-centred practice, highlighted occupational issues and made treatment planning more effective for the whole team.

This article documents an audit of the ward occupational therapy service in the Hartington Wing, an Acute Mental Health Unit in Chesterfield and North Derbyshire Royal Hospital NHS Trust. A revised service based on 'open-door' groups aims to make occupational therapy more accessible at the point of admission and more responsive to changing needs, and it drew praise at the unit's last visit from the Mental Health Act Commission. The findings of the audit demonstrate increased uptake of occupational therapy, with patient contacts almost doubling and the time taken from referral to first patient contact being significantly reduced. The ward nursing staff were positive about the changes but their perception of the occupational therapist's role in ward group programmes remains unclear.