Abstract
Date Presented 04/22/2023
This study explores the lived experiences of community-based adults with a serious mental illness (SMI). Five community members diagnosed with a SMI and five community-based OTs participated in semistructured interviews and a focus group. Six themes arose from content analysis. The authors conclude that it is imperative for practitioners to understand how these barriers affect participation and create better ways to understand and center the voices of this population.
Primary Author and Speaker: Adeola Solaru
Contributing Authors: Rochelle Mendonca, Christine Donovan
Adults with serious mental illness (SMI) experience barriers to community participation, however, they also have strengths that can be leveraged to improve their participation. There is limited literature and therapeutic methods that center the voices of this population. This study used a phenomenological approach to examine the lived experiences of community-based adults diagnosed with SMI related to receiving mental health care from the perspective of community members and their mental healthcare therapists. Convenience sampling was used for recruitment. All participants had to live within the United States, be over 18 years, and speak and read English. In addition, community members with SMI had to have a mental health diagnosis (bipolar, depression, schizophrenia) and live in the community. Occupational therapists had to have experience working with people with SMI for at least 1 year. Community members participated in one-on-one in-person interviews using a semi-structured guide. Occupational therapists participated in a focus group using a semi-structured guide via Zoom. Qualitative responses were analyzed using content analysis to develop categories and themes, by two independent coders. Themes that emerged from content analysis included: 1) barriers to participation; 2) facilitators to participation; 3) community-based care; 4) stigma and discrimination; 5) lived experience; and 6) provider input. Results showed that community members focused more on experiences of stigma and discrimination whereas occupational therapists focused more on access to resources. Community-dwelling adults with SMI identify the need to carry out activities in the community but also face barriers such as stigma and occupational injustice. It is imperative for practitioners to understand how these barriers impact participation, create better ways to center the voices of this population in assessment and intervention, and address barriers at the individual and systems levels.
References
Laliberte Rudman, D. (2013). Enacting the critical potential of occupational science: Problematizing the ‘individualizing of occupation’. Journal of Occupational Science, 20(4), 298–313. https://doi.org/10.1080/14427591.2013,803434
Blank, A., Harries, P., & Reynolds, F. (2014). ‘without occupation you don’t exist ’: Occupational engagement and mental illness. Journal of Occupational Science, 22(2), 197–209.
Fawcett, A. (2009). Principles of assessment and outcome measurement for occupational therapists and physiotherapists: Theory, skills, and application. West Sussex, England: John Wiley & Sons, Ltd. American Journal of Occupational Therapy, 48(7), 595–607. https://doi.org/10.5014/ajot.48.7.595
Barlott, T., Shevellar, L., Turpin, M., & Setchell, J. (2020). Destabilising social inclusion and recovery, and pursuing ‘lines of flight’ in the mental health sector. Sociology of Health & Illness, 42(6), 1328–1343. https://doi.org/10.1111/1467-9566.13106
