The development of an occupational therapy intervention for adults with a diagnosed psychotic disorder following discharge from hospital

Mary Birken,Mike Slade,Claire Henderson

doi:10.1186/s40814-018-0267-7

Abstract

BackgroundA deterioration in mental health and admission to an acute mental health unit can result in skill loss and decreased participation in daily life. Furthermore, discharge from hospital is associated with high risks of social isolation and suicide. This intervention development study aims to describe the rationale, methods and processes of developing an intervention for adults with a diagnosed psychotic disorder following discharge from hospital. The intervention aims to increase participation in self-care and leisure, wellbeing and quality of life and reduce crisis service use.MethodsThe UK Medical Research Council framework for the development of complex interventions was used to guide the process of developing the intervention to ensure the developed intervention is empirically justifiable and evidence based. The development involved a systematic and literature reviews and focus groups with people with psychosis and clinical staff to understand the problems the intervention should address and approaches to resolving these.ResultsA manualised 4-month intervention named Graduating Living skills Outside the Ward (GLOW) was developed for use by occupational therapists for people with a diagnosed psychotic disorder following discharge from hospital. The one-to-one stepped intensity intervention is of 4 months in duration and takes place in the person’s home and in community locations. The intervention aims to increase occupational performance of domestic and personal self-care, leisure and some productive roles.ConclusionsThe intervention developed in this study has potential to improve the efficiency of community mental health services following discharge from hospital as it is evidence-based, time-limited and manualised and aims to reduce hospital admissions and crisis service use. The intervention will be tested to assess its clinical and cost effectiveness in a randomised controlled trial.

Highlights

A deterioration in mental health and admission to an acute mental health unit can result in skill loss and decreased participation in daily life
This paper reports the process of developing an intervention called GLOW (Graduating Living skills Outside the Ward), for people with a diagnosed psychotic disorder post-discharge from hospital to increase self-care and leisure and increase wellbeing and quality of life
The developed intervention was named Graduating Living skills Outside the Ward (GLOW), by the service users who participated in the development of the intervention

Summary

Introduction

A deterioration in mental health and admission to an acute mental health unit can result in skill loss and decreased participation in daily life. Having schizophrenia is associated with high levels of unemployment [3], discrimination and social isolation [4] It is the most common diagnostic group to be admitted to acute mental health inpatient services [5]. Losing a job, having relationship problems and living alone have been found to be risk factors for committing suicide following discharge from hospital [9]. This supports the view that being able to take part in daily life is important for health and recovery from a relapse following discharge from hospital

Methods

Results

Discussion

Conclusion