It can be rather interesting listening to the things that OTs supposedly do in mental health wards/hospitals when I attend lectures. It’s a bit like, “Woah really, they actually DO STUFF??!” I should probably have a more positive attitude towards occupational therapy, especially as I’m studying to become an OT… I am only referring solely to OTs who work in psych wards though, as I do know that those in outpatient settings and rehab wards do a lot with their clients.Let’s face it, those of us who have been in psych wards possibly haven’t found occupational therapy to be all that helpful.
In the lecture yesterday, the OT used a person she had worked with previously as a case study, a young man who had been involuntarily admitted to hospital. According to her, an OT would do assessments with him, would do an interview and a Mental State Examination, establish a therapeutic relationship, set goals with the client, carry out interventions… Obviously I can’t claim to be aware of all the happenings within the ward, but I have very rarely seen OTs work one on one in such depth with inpatients. I thought all they did was conduct beading, painting, bored board games or cooking activities! Oh, and possibly a few groups in between.
So me being the cynical and pedantic person I am when it comes to provision of mental health care, I had to go up and ask the lecturers about whether this actually happens. I gave examples of three of the wards I’ve been on, saying that I haven’t really seen that happen. “Is this from personal experience, family members or….” asked one of the lecturers. “Umm, personal experience,” I answered. I can’t quite remember all of what they said, but they agree that in acute inpatient wards it can be more group work as well patronising, primary school level activities such as the art and sports ones. One of the lecturers explained that it also depends on how well the client is, as those who are on acute inpatient wards may not be ready to participate in the one to one actual occupational therapy intervention. Oh, and now all three lecturers who teach this unit recognise me. Heh, awkward.
I’m curious though, has anyone actually experienced proper occupational therapy in mental health, whether as an inpatient of outpatient, that was helpful?
The “occupational therapy” that we got while I was in the hospital consisted of games of Bingo (holiday themed!), and coloring cutout Christmas ornaments. I’ll list all the ways that this helped me become less suicidal:
*crickets*
I’ve had some really helpful OTs in previous admissions! 2 in particular who went out of their way to sit with me while distressed, teach me what I now know to be distraction techniques, try & teach me how to cook & reduce ED behaviours while cooking. Even simple things like when I was struggling, taking time to sit with me & encourage me to drink a cup of water because the nurses didn’t have time. These particular OTs worked really well with the rest of the treatment team, came to case reviews, etc. & I found their engagement to be invaluable. However I’ve had other admissions where OTs have been like “let’s play nintendo” & I’ve been like “nah” & they’ve been like…ok. I shan’t interact with you again! I think it really depends on the OT & how hard they’re willing to work with the patient & if what they’re willing to do fits in with the rest of the team. x
Yeah I’ve had some OTs do actual stuff with me. Sometimes they have done similar work as the social workers and tried to plan how I would go home, how to make home environment better etc. Others have taken a group of us young people on community outings such as taking some of the ones with anxiety to shopping centres and on buses. I’ve also had OTs take people with EDs out for snacks and coffee at a cafe. Then I’ve had ones that do craft etc with me. I actually really appreciated the craft and planned activities. I was extrememly ill when I was on a psych ward and just couldn’t plan anthing for myself or even really muster up any energy to do anything but sit in a chair all day. I actually owe so much of getting better to the planned OT activites, which maybe some of the well-er people found moind numbing… but were almost challenging for me. So I guess I’d say, don’t knock the massive benefits these activites can have for people just because you didn’t find them helpful. Everyone is different and you’d be amazed how some of the very sick people found a bit of relief from their illness during these sessions.
Also I had an OT work with me onceto help me start off the day each morning, eat breakfast, wash hair, change, clean room.
SSo yeah, hope that helped and showed you a few of the things OTs do!!
I want to present you with the Strong Person Award, you can find more details here: http://mycrazybipolarlife.wordpress.com/2012/08/25/1430-strong-person-award-even-when-im-not-feeling-so-strong/ Sorry if you have already received it, but you deserve it!
I’ve had some great help from OTs in an acute psychiatric ward here (UK). Had a couple of one to one cooking sessions, where the OT helped me with adapting stuff so things were less dangerous (I managed to frighten her a bit the first time
), and she took me to the new area I was moving to (was homeless when I arrived on the ward) to find the supermarket and other places so I would feel better there. I think she also went shopping with me once for some toiletries as I didn’t have any when I went in. That was really good (and helped her get an idea of what problems I had with travelling and shopping, so was part of her job).
The other activities also helped, the group cooking (which also involved a trip to the supermarket to get the ingredients for those allowed to leave the ward) and stuff. Some of them were run by OTs, some by activities coordinators, some by both. I found them really helpful, even the simple ones like colouring in. I discovered I was really really good at pictionary in one of them
One of the pieces of art I helped with is now in the front waiting area of the unit, which is cool.
I know a lot of the patients thought the activities were boring and pointless, but I got a lot out of them. Okay, it didn’t stop me being suicidal, but it was a slight distraction for a bit with people who weren’t there to interrogate me on how I was feeling.
In the (adult) inpatient units I was in, the OTs ran 1 of 3 groups daily – an art (coloring, glue) group and a hygiene group (nail care – I kid you not. nail polish was the only thing provided.) and a wellness group that consisted of handing out worksheets printed from the internet about holistic wellness (that one could find googling on his own). They were also present during meals but did not interact with patients at that time. It was mind-boggling to me that they received a salary for this. They did nothing that a babysitter would not be able to do.
I work with OTs professionally in a related field and have nothing but respect for them. After my hospitalizations my view of the profession, at least in the USA, did shift quite a bit. It has not been my impression that OTs who work in mental health do much, apart, perhaps from individuals with severe illness such as schizophrenia who may need help learning to do day to day basic tasks — again, something which most caregivers could easily provide without an OT background. This impression was further solidified by post-hospital discussion with OTs who do not work in mental health, who shared my impression that hospital based MH work was a serious easy out.
After my first admission, I started seeing an OT as an outpatient. She helped me to build up the courage and resources to find a job so that I could keep my house, and in the interim when I was not well enough to work, she did things like got some food donations from a charity for me and stuff. She didn’t seem amazingly adept at knowledge of mental health issues, nor was she completely comfortable dealing with a young person who had a vague idea of how the world worked, but she definitely helped me by breaking things down into small steps and encouraging me.
Then, of course, there is the crappy activities that come along with IP admissions, but tbh I have found comfort in them at times. (Well, the art stuff anyway, not really anything else.)
I’ve had good OT as inpatient and outpatient – in fact partly influenced me studying it myself. Yeh there were lots of group stuff – art, craft stuff, but found that helped me distract from negative thoughts, and also very slowly encouraged me to interact with others rather than isolate myself. went out off the ward to local community – was good to have the support to gradually increase my confidence. Before I did any of this I remember having a long one on one sort of chat (although I wasn’t really talking much) to see what were my interests. I think it needed an OT to realise what was meaningful to me, and how to grade it appropriately, and that that’s not something that any support worker could necessarily do (nursing assistants on the ward would think taking me for a walk around the block was enough).
Some of the stuff seems so obvious, esp when I’m well, but when I’ve been ill, obvious stuff goes out the window!!!
REally sorry to hear that you haven’t had a good positive experience of mh OT. You need to go out there and show them all how it should be done!
btw well done on at least asking the lecturers – and hey, if they know who you are, they know you know that things aren’t always as theory wants it to be!
tag