A Qualitative Study of the Role of Occupational Therapy in Mental Health Community-Based Settings Open Access

RESEARCH: This qualitative study explored the perceived role of occupational therapy (OT) in the community-based mental health setting.

RATIONALE: Mental health treatment has evolved, yet returned to where it first began—in the community. The treatment focus for OT has shifted back to an earlier emphasis on prevention and wellness, using daily activities within a natural context in order to provide a holistic perspective for intervention. The mental health treatment team often does not always represent a full complement of service providers because occupational therapists are often not included, resulting in a lack of meaningful, occupation-based interventions.

DESIGN: This study used a qualitative design with a phenomenological approach.

PARTICIPANTS: The participants were a convenience, nonprobability sample, recruited from local and surrounding mental health community-based outpatient clinics, partial hospitalization programs, and ambulatory settings with or without occupational therapists on staff.

Inclusion criteria for the participants in the study were licensed, clinical staff with ≥5 yr of professional experience; employed with the program or facility for ≥1 yr; provide clinical treatment to individuals with a psychiatric diagnosis; and work in a full-time/part-time or per-diem capacity.

METHOD: A semistructured interview guide was developed for this study, which was informed by previous work. A panel of three experts reviewed and provided feedback on the interview guide. A 30- to 45-min, individual, semistructured, in-person interview was conducted with participants. The interviews were audio recorded and then transcribed.

ANALYSIS: Data analysis occurred in a three-step process: verbatim transcription and repeated reading of the individual transcripts; line-by-line coding to identify similarities of verbiage used and links to the focus of the study; and thematic analysis that searched for recurring words, phrases, and direct quotes of the participants.

RESULTS: The seven emergent themes that were identified note that OT provides a different perspective, a consultative role, skill building, and wellness. Providers discussed a lack of use of OT, a lack of knowledge of OT, and the perception that mental health is outside the scope of practice for OT.

DISCUSSION: The study support the findings within the current literature, which highlights the underrepresentation of OT in community-based mental health. This may be due to the lack of knowledge/understanding of OT services, the shift from inpatient treatment to outpatient community treatment settings, or similar services provided by other skilled clinicians. The literature points out that many mental health service providers offer skilled service that is similar to OT with respect to treatment goals; however, OT addresses the needs of the service population holistically through the use of a variety of assessment and intervention modalities.

IMPACT STATEMENT: In previous research and the current study, an increase in the awareness of the role of OT would assist in many areas, more specifically interprofessional learning and working. This would promote the role of OT in the community-based setting as well as other settings. From interprofessional learning, the health care providers would be able to delineate the roles of each member of the treatment team. This would better prepare the future health care providers prior to entering the workforce, because it will also foster a more therapeutic alliance within the treatment, thus in enhancing the potential for a positive patient outcomes.