Mental Health Occupational Therapists Research Articles

Health resource utilization expenditures in oncology within a virtual primary cancer survivor care clinic.

e13785 Background: Unprecedented cancer treatment efficacy has led to high rates of disease sequelae. Lancet recently declared the failure to care for the human dimensions of cancer treatment a "humanitarian crisis." To address this humanitarian crisis, real-world economic evidence can improve patient access to whole person care through insurance reimbursement policies. Methods: We implemented a virtual primary cancer survivor care clinic that follows ASCO and NCCN guidelines for cancer survivors with emphasis on mental health, nutrition, physical activity, and sleep optimization. Our clinic utilizes medical oncologists, physician associates, mental health therapists, registered dietitians, and occupational therapists. Patient reported outcomes (PRO) monitor health status and inform treatment pathways. To reduce test fatigue, we use the SF12 Vitality Enhanced scale (SF12v2). The SF12v2 measures physical functioning, activities of daily living, pain, vitality, social functioning, and mental health. Total medical expenditures (MEs) is the sum of payments for hospital inpatient events, emergency room visits, home care, prescribed medicines, office-based and out-patient visits, and medical equipment. Patient SF12v2 summary scores predict a patient's total MEs. A one-point better physical component summary score and mental component summary score are associated with 2% lower MEs; 3 and 5 point score increases are associated with 10% and 18% lower MEs. Results: Patients were referred from a Utah community oncology clinic, other medical clinics, or self-referred (N=99). The mean patient age was 52 years. 84% were female, 16% were male. At enrollment, 35% had started treatment, 21% were on post treatment aromatase therapy or adjuvant hormonal therapy, 65% were post treatment. Baseline PRO reveal significant disease burden: 82% report poor mental health; 72% report poor physical health; 79% report poor cognitive health; 83% report sleep disorders. For patients who completed at least three PRO measurement time points (n=54): 91% had a positive clinical outcome for mental health; 70% had a positive clinical outcome for physical health; 89% had a positive clinical outcome for cognitive health; 76% had a positive clinical outcome for sleep health. As a result of these extraordinary outcomes, 74% of patients had lower predicted MEs. The average predicted reduction in MEs was 16% with an average annual savings of $1,629.49. Conclusions: Cancer is associated with high disease sequelae and high MEs. We believe this is the first study that reports real-world clinical evidence and predicts MEs for patients enrolled in a virtual primary cancer survivor care clinic. Real-world evidence demonstrates both clinically significant improvements in HRQoL and reductions in patient MEs. These results can inform insurance reimbursement policies, ensuring equitable access to cancer survivor care.

Abstract PO1-11-10: Use of a standardized tool for the evaluation and treatment of cancer related cognitive impairment (chemo-brain) among breast cancer patients

Abstract There is a steep linear increase in patients surviving a cancer diagnosis. Clinical solutions that address the high prevalence of cancer-related treatment effects (CRTE) are urgently needed. A stark example of this need is the dearth of screening and treatment programs for cancer related cognitive impairment (CRCI) (colloquially called “chemo-brain”). Up to 75% of cancer patients report neurocognitive changes that leave patients unable to cope with the expectations of employers, colleagues, families, and friends. The prevalence of neurological disorders is 275% higher among adult cancer patients, when compared to an adult cancer-free population. For many adolescent and young adult cancer patients, the onset of CRCI occurs during "cognitive prime time"; a time when individuals are pursuing education, careers, and raising families. To address a gap in CRTE we have implemented a virtual multi-disciplinary intervention to measure and treat CRCI. Our CRCI intervention follows National Comprehensive Cancer Network and American Society of Clinical Oncology (ASCO) guidelines for CRCI. These guidelines indicate a multi-disciplinary approach with emphasis on increasing physical activity levels, cognitive-behavioral therapy, memory adaptive training, mood management, and sleep optimization. Our approach also follows recent ASCO guidelines for nutrition counseling. Our CRCI program utilizes medical oncologists, physician assistants, mental health therapists, registered dietitians, and occupational therapists. A nationally validated patient reported outcome (PRO) measurement, analysis, and reporting platform informs clinical treatment pathways, monitors patient progress, guides clinical decision making, and improves patient/provider communication. Using health status measures for CRCI, and following American Cancer Society and ASCO guidelines, patients are risk-stratified into three personalized cancer survivor care pathways: 1) low-complexity patients; 2) medium-complexity patients; and 3) high-complexity patients. Low-complexity patients baseline PROs score in the normal range, medium-complexity patients are those who score below the norm (moderate to large effect size difference from normal), and high-complexity patients are those who score well below the norm (greater than larger effect size difference from normal). Low-complexity patients are enrolled into a self-management and continuation of care program. Medium-complexity patients are enrolled into a shared care program. High-complexity patients are enrolled into an acute care program. All three clinical pathways include continued risk-factor vital-sign surveillance. Nearly 100% (99%) of patients who enroll in our primary cancer survivor care program complete our PRO baseline (N=80). From a convenient sample of breast cancer patients (N=42), provisional results of patient-specific segmentation analyses reveal a nearly perfect bell-shaped curve, with 51% of the population classified within the definition of medium-complexity and even split of outliers (high-complexity 24% and low-complexity 24%). Additionally, of all patients in our primary cancer survivor care program who completed at least three measurement time points for health status measures of cognitive impartment (N=38), 92% had a positive experience, 71% had a clinically significant improvement in cognitive health, 21% had a no change in cognitive status, and only 8% had a decline in cognitive health. If these data, and PRO implementation approach hold true, this program could be scaled to national and international cancer survivor population suffering from CRCI. Citation Format: John Librett, Mark Kosinski, Gregory Litton. Use of a standardized tool for the evaluation and treatment of cancer related cognitive impairment (chemo-brain) among breast cancer patients [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-10.

Perceptions of Mental Health Professionals on Nutritional Psychiatry as an Adjunct Treatment in Mainstream Psychiatric Settings in New South Wales, Australia.

Background Nutritional psychiatry refers to the practice of using food, or nutrition, as alternative or complementary treatment for mental health disorders. It is a growing area of research that has shown links between the biological processes in the gut and how the food we consume can impact cognitive function, which then can impact our mood and behaviour. However, there is a lack of understanding on the knowledge and education of nutritional psychiatry in mental health clinicians, and further, how nutritional psychiatry, if at all, is practised in psychiatric clinical settings. Therefore, this study aims to investigate the perceptions, knowledge, and education of mental health professionals within the state of New South Wales, Australia regarding their clinical practice and knowledge of nutritional psychiatry. Methods In this cross-sectional study, a self-administered structured questionnaire created by the authors was successfully completed by 40 mental health professionals (mental health nurses, occupational therapists, psychologists, medical officers, and other allied health workers) who were working in New South Wales, Australia. 49 questionnaires were attempted with nine excluded due to these being predominantly incomplete, including demographic data only or empty,ensuring integrity of the remaining data and analysis. The questionnaire aimed to uncover their perceptions, knowledge, and education in nutritional psychiatry and its role in mental health settings. The questionnaire included 16 questions that covered various themes such as the frequency and importance of discussing nutrition with patients, nutrition referrals for issues regarding nutrition, the value of including nutritional psychiatry in their clinical practice, and clinician training and willingness to train or gain further education in nutritional psychiatry. Data was analysed through a series of frequency tables to categorise patterns and identify patternsthrough the use of descriptive statistics in our analysis of the distribution of attitudes and practicesamong mental health professionals regarding nutritional psychiatry. Results A total of 40 mental health clinicians successfully completed the survey and their results were analysed. The results suggest that most clinicians (85% to 93%) recognised the importance of nutrition in mental health, however, revealed variousbarriers which hinderedtheir clinical practice such as a lack of time, knowledge, and access to nutritional services. Further, 54% of clinicians rated their knowledge of nutritional psychiatry as low, however, 92% revealed that they would attend nutritional psychiatry training if given the opportunity. Additionally, the clinicians reported varied levels of education in nutrition, with 43% reporting no education at all on nutrition in their preclinical studies. Conclusions Clinicians recognise the importance of nutrition in mental health settings, but revealed lack of time, knowledge, and nutritional services as barriers in clinical practice. Further, clinicians reported a lack of pre-clinical education on nutrition together with an overwhelming interest in engaging with nutritional psychiatry education if it were made available. These conclusions provide important insights for higher education and health policy.

Supporting self-determination in mental health recovery: Strategies employed by occupational therapists.

Self-determination is a core component of mental health recovery and a predictor of positive outcomes. The literature calls for occupational therapists to lead practice change to greater recovery-orientation, including facilitating people's self-determination. However, systemic challenges thwart translation of policy into practice and therapists report a lack of confidence in implementing recovery-oriented principles. This study aimed to understand the strategies that mental health occupational therapists employ to support people's self-determination. Data were collected through an international on-line questionnaire principally comprising two open-ended questions designed to elicit deep reflective personal accounts. Participants were asked about an experience in which they supported a person's self-determination and the factors that either facilitated or hindered this experience. Qualitative data were analysed using inductive thematic analysis, guided by constant comparative methods. Thirty-four therapists, predominantly from Australia (n = 30), participated. Therapists described supporting self-determination as a multifaceted process that involved: (1) working on myself, (2) working with the person, and (3) working with others. They emphasised that the combined use of various strategies across these three areas of work was important to support people's self-determination. Further, awareness of and addressing issues of power in their practice was key. This study supports the translation of recovery-oriented principles into practice by revealing the nuanced strategies implemented by occupational therapists striving to support self-determination. Participants employed diverse strategies to empower people to take the 'driver's seat' in their mental health recovery journey. Insights from this study will support other occupational therapists to actualise recovery-oriented principles and better support self-determination in their practice. To effectively implement self-determination strategies, therapists must reflect on and address existing power differentials within mental health services, particularly between themselves and the people they support.

The experience of healthcare professionals implementing recovery-oriented practice in mental health inpatient units: A qualitative evidence synthesis.

WHAT IS KNOWN ON THE SUBJECT?: The principles of personal recovery are primarily applied in outpatient and community settings as these settings provide continuity of care and recovery-based community programs supporting consumers' recovery journey. A range of healthcare professionals are involved in the care of people within mental health in-patient units, including nurses, psychiatrists, psychologists, occupational therapists and social workers. The integration of recovery-oriented care in mental health inpatient units may be impaired by a lack of confidence among mental health professionals. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Developing hope and a safe place is an integral part of recovery-oriented practice within mental health inpatient units. Instilling connectedness is a relevant recovery principle; however, there may be greater barriers in mental health settings which traditionally prioritise safety and risk mitigation practices to prevent perceived harmful behaviours. Staff workload and inadequate understanding of recovery concepts present challenges to promoting recovery-oriented care in everyday practice. Using strength-based practice is critical in promoting a safe space for consumers by providing psychosocial interventions and person-centred care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The provision of recovery-oriented practice requires adopting a collaborative approach that places a strong emphasis on the involvement of consumers and their families. Empowering mental health professionals to believe that recovery-oriented practice is possible in mental health inpatient units is crucial. Mental health professionals need to create a safe environment and positive relationships through respect and empathy for consumers and their family members. ABSTRACT: Introduction Recovery-oriented practice underpins an individual's personal recovery. Mental health nurses are required to adopt a recovery-oriented approach. Globally, a paucity of literature exists on mental health professionals' experience of recovery-oriented practice in mental health inpatient units. Aim The aim of this synthesis was to explore the experiences of healthcare professionals regarding recovery-oriented care in mental health inpatient units by appraising and synthesising existing qualitative research. Method Three databases, including MEDLINE, PsycINFO and CINAHL were searched between 2000 and 2021. Data were extracted and synthesised using thematic integrative analysis. The quality of included studies was assessed with the CASP Critical Appraisal Checklist. Results Ten qualitative research projects met the inclusion criteria. Four themes were identified (i) developing a safe and hopeful space, (ii) promoting a healing space, (iii) instilling connectedness and (iv) challenges to realising recovery-oriented care. Discussion Mental healthcare professionals perceived the principles of recovery-oriented care to be positive and include: therapeutic space, holistic care and person-centred care. Nevertheless, findings revealed limited knowledge and uncertainty of the recovery concept to be key barriers that may hinder implementation into practice. Implications for Practice Recovery-oriented practice must underpin consumer and family engagement, treatment choices and continuity of care to facilitate consumer's personal recovery.

A Qualitative Synthesis Exploring the Potential Role for Mental Health Occupational Therapists Working with Patients in Seclusion

Despite guidance to minimize restrictive practice within the UK, seclusion and long-term segregation are necessary to maintain the safety of patients and clinicians. There is little evidence to guide the work of occupational therapists with secluded patients. A literature search identified seven papers that met the study inclusion criteria. A deductive approach to thematic analysis was conducted using the ‘Model of Human Occupation’ as a theoretical framework to identify issues related to occupational need during a period of seclusion. Findings indicate ways in which occupational therapists could engage with patients in seclusion and suggest a need for future research.

"Kickstart to Recovery": An Irish Football Program for Mental Health Service Users.

The "Kickstart to Recovery" program is a collaboration between Irish mental health occupational therapists and the Football Association of Ireland. This pilot study aimed to investigate whether participants experienced changes in quality of life, recovery, social gains, and the meaning of football following participation in the program. A quantitative pre-post study design was employed, with 27 participants completing a questionnaire consisting of outcome measures aimed to measure the above changes. Findings revealed statistically significant improvements in the Short Form 36 Health Survey Questionnaire (SF-36) "Energy/Fatigue" domain for the total sample and the Recovery Assessment Survey-Domains and Scales (RAS-DS) "Mastering My Illness" domain for first-time program participants. Statistically significant results were found for domains of "Social Functioning" and "Emotional Wellbeing" in groups incorporating additional social elements. The Engagement in Meaningful Activities Survey (EMAS) showed no change for the personal meaning participants attributed to football; however, high pre-test scores were noted. The "Kickstart to Recovery" program is attributed as a possible factor contributing to these results.

Distance supervision as experienced by occupational therapists in mental health: An interpretative phenomenological study

Introduction: Distance methods of supervision rapidly increased in use during the coronavirus disease 2019 (COVID-19) pandemic, and it is important to consider if these methods meet the needs of supervisees when deciding whether to retain these practices moving forward. Methods: An interpretative phenomenological approach was used to gain insight into the lived experience of distance supervision. Semi-structured interviews were completed with six occupational therapists who had experience receiving distance supervision as a supervisee, all of whom work in inpatient mental health units within a private healthcare company. Results: Interpretative phenomenological analysis revealed four superordinate themes of an altered interaction; the importance of a protected space; factors within the supervisory relationship and maximising the best of both worlds. Conclusion: Distance supervision methods afford increased access for supervisees and a reduction in the practical demands when supervised by an off-site supervisor. There are, however, clear differences in the nature of the experience which need to be considered to ensure that supervisee needs are met. This study provides insight into how distance supervision methods impact on the experience for supervisees and suggests areas for further consideration in moving forward with such approaches.

Eye movement desensitisation and reprocessing as a treatment for PTSD, trauma, and trauma related symptoms in children with intellectual disabilities: a general review

PurposeThis paper aims to discuss the utility of eye movement desensitization and reprocessing (EMDR) therapy as a treatment for children with intellectual disabilities (ID) who have experienced trauma.Design/methodology/approachRelevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide support for the use of EMDR as a treatment for trauma in children with ID.FindingsThere is a growing body of evidence which demonstrates that EMDR therapy is successful for the treatment of trauma in adults and children. However, for children with ID, the research is limited despite those with ID being more likely than non-disabled peers to experience trauma such as abuse or neglect.Practical implicationsEMDR can only be facilitated by trained mental health nurses, psychiatrists, psychologists (clinical, forensic, counselling or educational) or occupational therapists or social workers with additional training. Finally, general practitioners who are experienced in psychotherapy or psychological trauma and have accreditation. Therefore, this highlights that there may be a lack of trained staff to facilitate this intervention and that those who are generally working with the client closely and long term such as learning disability nurses are not able to conduct this intervention.Originality/valueThis paper presents an account of NICE guidance and evidence of the efficacy of EMDR as a treatment for adults, children and those with ID.

Clinical practices, challenges, and job satisfaction of occupational therapists working in Community Mental Health Centers in Turkey

Introduction:Occupational therapists have been involved in Community Mental Health Centers (CMHCs) since 2016 in Turkey. To the best of our knowledge, no data about occupational therapists’ practices in CMHCs is available in the extant research literature. Therefore, this study aimed to investigate the clinical practices, challenges, and job satisfaction of occupational therapists working for CMHCs in Turkey.Method:We conducted a cross-sectional survey study in which 28 volunteer occupational therapists working in CMHCs participated. The participants filled out the Sociodemographic and Professional Experience Information Form and the Job Satisfaction Scale.Results:Occupational therapists were experienced practitioners implementing various occupational therapist practices in community mental health and they were generally satisfied with their job. The challenges facing Occupational therapists were communicating with caregivers, motivating the client, enabling the client to perform occupational participation. Collaborative teamwork and participation in training about community mental health were found as the important factors contributing to occupational therapist professionals’ job satisfaction.Conclusion:Investigating the professional behaviors of Occupational therapists, an emerging health profession in Turkey, is important for the development of the profession. The education and supervision specially adapted for community mental health and the supportive teamwork seem to be significant for the job satisfaction of community mental health Occupational therapists.

History of Mental Health Service in Korea and Entailment of Mental Health Occupational Therapists According to Amendment to Mental Health Act

History of Mental Health Service in Korea and Entailment of Mental Health Occupational Therapists According to Amendment to Mental Health Act

Research capacity and culture in an Australian metropolitan public mental health service: scoping the skills and experience of social workers and occupational therapists

BackgroundInvestment in a clinical research culture appears to be associated with benefits for consumers, staff, and overall organisational performance. The validated 55-item Research Capacity and Culture (RCC) tool was developed specifically to gauge the research capacity and culture of health professionals and workplace settings within which they work. Results of some individual studies suggest that professional discipline and workplace setting may impact RCC results however it has never been used in a dedicated public mental health setting. Therefore, this study will explore the research capacity and culture of allied mental health clinicians (Part 1). Another aim is to explore potential connections between workplace settings, locations and disciplines based on published RCC-based data to help signpost potential impediments to service improvements (Part 2).MethodsPart 1: An RCC-based online survey canvased Australian Social Workers and Occupational Therapists (n = 59) based in a metropolitan public mental health service. Non-parametric analyses explored links between research-related experience and participant characteristics.Part 2: Comparative analyses explored the potential influence of workplace settings and professional disciplines on published RCC results.ResultsPart 1: Overall, the research capacity and experiences of mental health Social Workers and Occupational Therapists seemed modest. Discipline was statistically associated with level of research-activity experience, weighted towards occupational therapy; demographic characteristics were not. Only two items in the RCC were rated high; many more items were rated low.Part 2: Published studies exploration found no link between RCC ratings and workplace location, setting, or professional discipline. Sampling biases and use of modified, non-validated RCC versions likely impacted the results.ConclusionsAllied mental health clinicians may not be sufficiently experienced, knowledgeable, or confident with a range of research-related activities given the emphasis on workforce research capability in policy and practice nowadays. This may be commonplace across health-based organisations. We recommend the systematic implementation of research training programs in (mental) health services, and a ‘whole-of-service levels’ approach be used i.e., transform policy, culture and leadership as well as provide practical resources with individual training. Potential benefits include a positive impact on organisation functioning, clinicians’ confidence and practice, and improved consumer outcomes.

A Scoping Review Exploring the Use of Art-Making-as-Therapy in Adult Mental Health Occupational Therapy Practice

Background: Art-making-as-therapy has been used by occupational therapists in mental health since the inception of the profession. It aims to enable people to gain mastery and produce art. This review synthesizes the research on the use of art-making as therapy by occupational therapists in adult mental health practice.

Impact of strengths model training and supervision on the therapeutic practice of Australian mental health clinicians.

This study explored the impact of Strengths Model training, supervision and mentorship on the practice of a group of multi-disciplinary mental health clinicians that included mental health nurses, social workers, psychologists, and occupational therapists. A qualitative approach that combined critical realism and grounded theory was used. The findings demonstrated how a substantive category, Getting to Know Clients Better, facilitated participants' progression through a basic social psychological process, Becoming a Strengths-Informed Practitioner. This process consisted of a discernible and sustained change towards more person-centred, hopeful, and recovery-oriented practice. The findings also described an underlying generative mechanism for this, the Client Becomes Visible, which accorded with theoretical models of empathy, based on enhanced cognitive processing. The strength-based approach to practice facilitated the establishment of a collaborative relationship and a stronger therapeutic alliance between the client and clinician. The research demonstrated that Strengths Model is an effective vehicle for improving recovery-orientated mental health services.

“After Hello”: Exploring Strategies Used by Occupational Therapists Working in Mental Health Settings to Initiate Positive Therapeutic Relationships With Service Users

The importance of a therapeutic relationship in mental health care is well-established. There is however a need for further research in this field to gain an insight into techniques used by occupational therapists to develop and maintain this all-important relationship. This study uses thematic analysis of semi-structured interviews to explore mental health occupational therapists’ understanding of the therapeutic relationship. Three themes were identified: (i) the importance of positive engagement, (ii) specific strategies and techniques used to initiate this relationship and (iii) maintaining boundaries. The study further indicated that the development of therapeutic rapport takes time and opportunities for therapists to engage with service users in seemingly “non-directed” activities should be valued and retained.

Early career programs for mental health occupational therapists: A survey of current practice.

Early in their career, occupational therapists may require a range of additional development for a successful transition to the profession. However, both the definition of 'early career' and the relevant development for this career stage vary between sources. In regard to occupational therapists transitioning to mental health professional practice, there is very little evidence to draw upon when designing the structure and content of development programs. This study aimed to review current practices in early career programs for mental health occupational therapists within the Australian state of Victoria. Tertiary mental health services in Victoria were purposefully recruited, supplemented by snowball recruitment. The participants responded to a bespoke survey including open and closed questions, designed to benchmark practices against previous research and explore current practices with early career mental health occupational therapists. Thirteen services participated, with respondents including senior clinicians, allied health chiefs, allied health clinical educators and early career development program coordinators. The participants confirmed the perceived value of development programs for early career mental health occupational therapists; however, limited resources were available to develop, implement and sustain these supports. Program content, structure and terminology varied significantly, as did the identified competencies for participants to achieve. Some of this variability was related to program eligibility criteria and early career workforce structure within organisations. Early career mental health occupational therapist development should be responsive to their local service environments. A better understanding of the outcomes of these programs for early career occupational therapists, from both an individual and service perspective, could also provide a firmer rationale and foundation for sustained resourcing of this valuable approach to workforce development.

Novel models of dementia care: Evidence from national dementia behavior support programs in Australia

AbstractBackgroundBehaviors and psychological symptoms of dementia (BPSD) are frequently experienced by this population, as they reflect unmet biopsychosocial needs.[1] The occurrence of BPSD can be debilitating, distressing and impair quality of life, not only for the person living with dementia but also for their caregivers.[1] As such, people with BPSD have complex care needs that demand dedicated resources, tailored programs and specialized skills which are often missing in mainstream aged care services. To address these needs and to achieve a nationally consistent approach, the Australian Government has been funding the services of Dementia Support Australia (DSA). DSA is the leading national provider of 24/7 dementia‐specific behavior support programs in Australia. DSA programs include the Dementia Behavior Management Advisory Service (DBMAS) for mild‐moderate BPSD and the Severe Behavior Response Teams (SBRT) for moderate‐severe BPSD. These programs entail person‐centered and multimodal nonpharmacological, psychosocial and/or psychoeducational interventions to support people with BPSD and their caregivers. These are achieved through a case management framework that includes an onsite comprehensive/holistic assessment of medicosocial history (e.g. pain), surrounding environment (e.g. over/under‐stimulation) and prescribed medications to identify causes or triggers of BPSD (Figure 1).[1] DSA is delivered through a multidisciplinary and mobile workforce of dementia consultants, geriatricians/psychogeriatricians and support staff. DSA consultants are accredited against an industry‐specific program focused on dementia‐specific competencies and capabilities. Consultants include, but are not limited to, registered and mental health nurses, occupational therapists, physiotherapists, social workers, psychologists, dieticians, speech pathologists, and diversional therapists with significant experience working in dementia and aged care settings. Since establishment in 2016, DSA programs have supported over 30,000 client referrals from residential, community and acute care settings and have supported >80% of residential aged care homes in Australia. Typical demographics for DBMAS and SBRT clients are displayed in Figure 2. Data collected on referrals demonstrated reduced frequency and severity rates of BPSD and high levels of caregiver satisfaction. Thus, DSA programs provide a novel, effective, feasible and sustainable model of care and service delivery specifically designed to address perceived gaps in aged care systems.

Exploring the professional experiences of mental health occupational therapists during a period of COVID-19

Purpose: The COVID-19 pandemic has brought about disruption in the way health-care professionals carry out their day-to-day practices across communities. The purpose of this research paper is to explore the professional experiences of occupational therapists working in community and rehabilitation mental health settings during a period of the COVID-19 pandemic and to help gain an understanding of how their day-to-day work practices have been affected. Design/methodology/approach: A qualitative phenomenological research study explored the lived experiences of ten occupational therapists working within Health Service Executive community and rehabilitation mental health services during the COVID-19 pandemic. Participants included eight community mental health occupational therapists and two rehabilitative mental health occupational therapists. Data was collected through semi-structured interviews and analysed using reflexive thematic analysis. Findings: Three themes were identified: holding on to what we do;technology: friend and foe;and COVID as a catalyst to clarify the occupational therapy role. These themes capture the community changes, challenges and frustrations experienced by the occupational therapists while striving to provide quality mental health occupational therapy services during the pandemic. Originality/value: The findings demonstrate the adaptive nature of the profession, the importance of traditional observation methods of community-based care, the experiences with telehealth approaches and an opportunity to clarify misconceptions of aspects of the profession’s role in relation to employment-related issues and occupational therapy group work within such mental health settings. © 2021, Brendan Culleton.

Occupational therapy interventions in mental health: a scoping review of recent evidence

Background/Aims Studies investigating the effect of occupational therapy in mental health are few. This scoping review aims to identify, present and assess studies that have investigated the effect of occupation- and activity-based/focused interventions performed by occupational therapists in mental health. Methods The scoping review involved searching six databases, covering articles from 2003 to 2018. ‘The Matrix Method’ was used to describe and synthesise the content of the included studies. The Oxford Level of Evidence was used to rank the evidence, and The Critical Appraisal Skills Programme was used to assess the quality of the study. Results A total of 21 original studies and 4 systematic reviews were included in this review. Interventions, approaches, programmes, training, and activities such as cooking, artwork, crafts, pottery, sports, calligraphy, horticulture, and music, organised individually or in groups, were investigated in the included studies. Individualised occupational therapy showed clinically significant improvements in social functioning and cognition, promising results were found on supported employment and education. Conclusions Few high-quality studies that have investigated the effect of occupation-and activity-based/focused interventions performed by occupational therapists in mental health were found. This scoping review highlights the importance of future high quality studies to support evidence-based practice within mental health occupational therapy.

Relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational therapists working in mental health.

The core tenet of occupational therapy is that engaging in meaningful occupations promotes health and wellbeing. Despite this, surprisingly little research has explored the meaningfulness of occupational therapists' own work. Occupational therapists in mental health have been identified as at risk of poor work-related wellbeing, therefore, it is important to explore potential 'protective factors' that may support wellbeing. Meaningfulness of work may be one such factor. This study was established to explore the relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational therapists working in mental health. Participants (N=118) completed a time use diary and measures of job satisfaction, burnout and professional identity. 'Meaningfulness of work activities' was constructed from respondents' ratings of each work activity according to client-relatedness, occupational therapy specificity and value of the activity to the individual, clients and families and colleagues. Relationships between meaningfulness of work activities, job satisfaction, burnout and professional identity were explored using bivariate correlations and stepwise regression. Analyses were also conducted to examine differences between individuals in working in 'generic' roles and those in 'occupational therapy specific' roles. Higher levels of meaningfulness of work activities were associated with higher job satisfaction, lower burnout and stronger sense of professional identity. The element of meaningfulness of work activities of 'value to self' was the most influential in terms of associations with each of the measures. There were no statistically significant differences in ratings of job satisfaction, burnout or professional identity between respondents in 'generic' and 'occupational therapy specific' positions. Efforts to increase the meaningfulness of work activities for occupational therapists in mental health may enhance work-related wellbeing. Supporting staff to engage in work duties they find valuable through individualised work allocations across teams may be an innovative approach to improve staff satisfaction and wellbeing.