Occupational Therapy Consultation for Case Managers in Community Mental Health

Abstract

Statistically significant differences in job satisfaction and perceptions of self-efficacy were found 18 months into the study, when case managers were more actively seeking occupational therapy consultation services and were reporting improved client outcomes from occupational therapy intervention. In addition, themes related to both positive and negative factors impacting the occupational therapy consultation program were identified and provided useful data for development of future consultation services. IMPLICATION FOR CASE MANAGEMENT PRACTICE: Results suggest that ongoing training and professional support for case managers who are paraprofessionals and/or new to mental health practice may improve job satisfaction and efficacy. Occupational therapy consultation may be helpful in developing services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification. In addition, new graduates and paraprofessional case managers working with clients who are high utilizers of services may benefit from smaller caseloads and support from clinical professionals.

Occupational Therapy in Integrated Primary Care: Addressing the Needs of Individuals Experiencing Homelessness

“…The context of homelessness combined with health co-morbidities puts individuals at higher risk of cognitive impairment and decreased opportunity to use and develop functional skills (Burra et al, 2009;Helfrich & Synovec, 2019). Studies identifying valued occupations of homeless individuals revealed varied priorities and goals, with attention to survival, identity and social connectedness, and self-care (Chapleau et al, 2011;Illman et al, 2013;Marshall et al, 2017;Muñoz et al, 2006;Salsi et al, 2017;Thomas et al, 2017). This population can benefit significantly from access to occupational therapy in order to develop functional living skills, address underlying cognitive deficits, increase self and health management skills, and to more easily transition to and maintain independent living through occupational engagement (Gutman & Raphael-Greenfield, 2017;Helfrich & Fogg, 2007;Roy et al, 2017;Thomas et al, 2017).…”

“…In the United States, there is a growing consensus in the profession that occupational therapy can have a significant role on interdisciplinary teams in integrated primary care settings serving clients with complex chronic conditions (Pape & Muir, 2019;Winship et al, 2019). There is limited research, however, on the role of occupational therapy in primary and integrative health care, especially on the impact on clients or contributions to the interdisciplinary treatment team (Chapleau et al, 2011;Dahl-Popolizio et al, 2016;Koverman et al, 2017). There have been many studies promoting efficacious community practice through integrated health delivery models, such as FQHCs, in which care for those with chronic, complex conditions is coordinated and delivered by a consistent group of providers, indicating a benefit to co-location of occupational therapy services in community settings (Dubuc et al, 2013;Ellis & Alexander, 2016;Engineer et al, 2015;Montenegro et al, 2011;Rumball-Smith et al, 2014).…”

“…In addition to responsiveness, the COPM has also been found to be a valid and reliable measure to detect changes in a client's self-perception of occupational performance over time (Law et al, 2014). The COPM has also been used to identify occupational performance needs in adults experiencing homelessness, although in these studies it was not used as an outcome measure (Chapleau et al, 2011;Muñoz et al, 2006;Salsi et al, 2017).…”

Role of Occupational Therapy in Case Management and Care Coordination for Clients With Complex Conditions

“…The founders of occupational therapy were from various disciplines, including medicine, nursing, architecture, and social work (Quiroga, 1995), so by nature of occupational therapy's founding circumstances, the profession recognizes and values collaboration. Chapleau, Seroczynski, Meyers, Lamb, and Haynes (2011) noted that occupational therapy adds valuable contributions to team outcomes because it includes "services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification" (p. 71).…”

“…Anecdotally, compensation for case managers typically is not competitive with traditional compensation for occupational therapy practitioners, who generally are paid more than nurses and social workers (Bureau of Labor Statistics, 2015). However, occupational therapy practitioners are frequently sought out to consult with case managers because of their expertise in understanding how people function in their homes and communities and perform independently at home, work, and school (Chapleau et al, 2011). Occupational therapy practitioners must take advantage of opportunities to consult and thus promote the broader case management skills they possess to further interdisciplinary knowledge and awareness of occupational therapy.…”