As Painted Brain’s initial occupational therapy doctoral resident, my task is to develop an occupational therapy service line that coincides with Painted Brain’s mission to provide opportunities for socialization and community integration to adults with mental illness. An initial step in this endeavor involves developing a deep understanding of why occupational therapy is perfectly suited for this work, and why a community-based organization, such as Painted Brain, is perfectly situated to offer this type of service.

Occupational therapy is a holistic health service that is integral to the recovery process, due to expertise in the areas of occupational engagement and participation, activity analysis, group dynamics, neurophysiology, environmental evaluation and adaptation, and psychosocial skill development. The term ‘occupation’ refers to a variety of activities that humans engage in on a daily basis, and these activities fall into categories such as “self-care”, “leisure”, “work or productivity”, and “rest”. A person’s state of health is related to the extent which a person is able to find balance between these categories of activities, as well as to the extent that the activities provide meaning to the individual’s life and opportunity for rich social connection; likewise, the ability of the person to engage in a balanced routine of meaningful activities in society is impacted by the state of the person’s health (Bejerhold & Eklund, 2007; Edgelow & Krupa, 2011).

Evidence shows that people with mental illness are at high risk for lack of engagement in meaningful activities, exclusion from important social roles, such as employment and parenting, and restricted engagement in community participation (Edgelow & Krupa, 2011). Barriers to engagement vary widely, and not only include the experience of symptoms of mental illness and the side effects of medications prescribed to treat such illnesses, but also include external factors, such as community resources, societal stigma and discrimination, and traditional mental health service delivery models that fail to view the person in a holistic manner.

Engagement in activities involves dynamic interaction between the person, the environment, and the activity itself. Thus, occupational therapy’s holistic lens is critical to providing interventions that facilitate balance in activity engagement. For example, the characteristics of the person (i.e. values, interests, age, culture) contribute to the choices that a person makes. The environment (i.e. where a person lives geographically, socioeconomic status, urban versus rural setting) delineate the choices that are available to the person. The chosen activity will affect the outcome of the experience due to the nature of the activity, the materials involved, and the meaning that emanates from the person’s interpretation of the activity. Over time, a continued routine and balance of meaningful activities, in environments that offer an opportunity for social connectivity and important social roles, contribute to a person’s sense of self and overall well-being (Bejerhold & Eklund, 2007). A study by Bejerhold and Eklund (2007) found a positive correlation between occupational engagement and quality of life, and a negative association between occupational engagement and symptoms of schizophrenia. These results confirm the construct that people who have higher participation in a variety of meaningful activities experienced a higher quality of life, but also illustrates that balanced engagement in meaningful activities is integral to the recovery of persons with mental illness.

Access to occupational therapy is a key factor in facilitating engagement and participation in meaningful activities for adults with mental illness. By providing access to quality occupational therapists, on both an individual and group basis, Painted Brain is augmenting its mission to provide adults with mental illness with opportunities for socialization and community reintegration. Ultimately, Painted Brain’s occupational therapy services will help individuals prevent mental health crises, develop and maintain mental health, and recover from mental health challenges, such that they may realize their full potential as positively contributing members of society.

References

Bejerhold, U. & Eklund, M. (2007). Occupational engagement in persons with    schizophrenia: Relationships to self-related variables, psychopathology, and quality of life. American Journal of Occupational Therapy, 61, 21-32

Edgelow, M. & Krupa, T. (2011). Randomized controlled pilot study of an occupational time-use intervention for people with serious mental illness. American Journal of Occupational Therapy, 65, 267-276. doi:10.5014/ajot.2011.001313