Sustaining a Focus on Occupation in Community Mental Health Practice

Abstract

Occupational therapists working in community mental health teams (CMHTs) are often challenged to justify their unique approach to health through occupation, within an environment that tends to press for generic working. Such a challenge requires practitioners to identify and communicate evidence that supports their unique occupational contribution. In the absence of extensive robust and relevant research evidence, it is suggested that the contribution of theoretical evidence be considered. This paper, therefore, explores the potential of occupational justice and its related concepts to provide the profession with a theoretical justification for occupational therapists adopting an occupation-focused role in CMHTs. It begins with an overview of how CMHTs, generic working and occupational science have evolved. The concept of occupational justice and its related occupational risk factors are then analysed in relation to practice. The potential conflict between the professional commitment to client-centred practice and the generic worker model is also discussed. The paper concludes with recommendations for further exploration and consideration.

A Critical Reflection on Occupational Therapy within One Assertive Community Treatment Team

“…Similarly, as M examined the challenges that 0 would need to face as he adapted to living in the group home, it is possible that the concept of occupational balance may have aided her in bringing more of an occupational focus to the assessment and intervention (Matuska & Christiansen, 2008;Pettican & Bryant, 2007). However, the current study suggests that present theoretical models do not yet include sufficient understanding of the complexities of maintaining occupational balance while living with a chronic mental health condition and adjusting to a new physical and social environment.…”

From the rhetoric to the real: A critical review of how the concepts of recovery and social inclusion may inform mental health nurse advanced level curricula — The eMenthe project

“…There is limited critical appraisal within the literature of the implementation of the 10 ESCs and since the change of government in the UK in 2010; there has been no obvious statutory reference to the (Pettican and Bryant, 2007), Psychiatry (Dogra and Karim, 2005;Lester and Gask, 2006) and Psychologists (Harper et al, 2007). However, there is little in the literature that may directly apply concepts of recovery and social inclusion to mental health nurse education.…”

Preparation for an uncertain world: Professional agency and durability in the practice preparation of mental health in occupational therapy

“…Proceeding debate within the professional literature focussed on the occupational therapy pre-registration curriculum; key areas of contention focussed on the mental health component and the importance of professional core skills 9,17,18 . Professional insecurity and role uncertainty experienced by occupational therapists working in mental health have been well documented over the past decade 20,21,22,23,24,25,26 . Reasons for this uncertainty are varied, yet tend to be linked to the fact that the scope of our practice is both broad and individualistic.…”

“…Contemporary practice is a fluid, challenging responsibility, which requires practitioners to work with heavy caseloads, in complex situations often of an indeterminate nature 29 . Practitioners need to develop capacity to be knowledgeable about their specific contribution and to make explicit their professional understandings 26,29 .…”

“…An area of significant tension revolves around practitioners' adoption of generic skills for broad-spectrum mental health working whilst striving to maintain an element of profession-specific practice. This has been most notably experienced within community mental health teams where consensus regarding the optimal type of casework for occupational therapists has not been reached 26,30 . Consequently graduates need to project a strong professional identity, demonstrate skills in evidence-based practice, critical thinking and resilience 31,32 .…”