Occupational Therapy News OTnews July 2019 | Page 29

MENTAL HEALTH FEATURE
Birken and Bryant (2019) used a participatory
visual method, Photovoice, to investigate how
specific occupational therapy environments were
experienced by service users in an acute UK mental
health unit through photographs taken that captured
their experience. Participants (n=5) engaged in ten
weekly research group sessions. Photographs of
different rooms were analysed through participatory
analysis. Seventeen photographs were selected for
the final set, with accompanying statements. The
paper presents the findings ‘room by room’ (kitchen,
garden, art room, gym and internet café). Findings
included that the occupational therapy department
offered a therapeutic environment to promote self-
management and recovery. However, the way staff
enabled access to the department’s resources was
considered important.
trained to deliver Recovery College courses). Reference
Birken M, Bryant W (2019) A Photovoice study
of user experiences of an occupational therapy
department within an acute inpatient mental health
setting. British Journal of Occupational Therapy, Apr
29. [Epub ahead of print].
Concept and clinical reasoning
The NSFT Recovery College offers a one-day course based on
the Five Ways to Wellbeing. However, a separate course called
‘Exploring Five Ways to Wellbeing’ was created to meet the needs
of students within an inpatient setting.
The Five Ways to Wellbeing are a set of evidence-based actions
to improve personal wellbeing (Aked et al 2008) around social
relationships, physical activity, awareness, learning, and giving.
Promoting good mental health and wellbeing is a key strategy
for the general population, as well as for those with mental health
problems. Improved mental health and wellbeing is associated
with better outcomes for everyone if they are empowered to take
responsibility for their wellbeing (DH 2011).
The Five Ways to Wellbeing course was therefore chosen
specifically to adapt for the acute wards for universal appeal, as
these simple actions are generic for people of all ages.
The Recovery College Five Ways to Wellbeing course is a
creative, practical session, which we felt would work well on the
wards. This is consistent with the underlying occupational therapy
philosophy of learning through doing and encourages students to
apply learning in a meaningful way.
During the co-production phase, practical group activities
were also selected to be accessible to inpatient learners and to
foster peer/social support, creating an environment for exploring
recovery together.
Practicalities of the sessions
‘Exploring Five Ways to Wellbeing’ is a course comprising of five
sessions, with each session covering one of the Five Ways to
Wellbeing: connect; be active; take notice; keep learning; and give.
The aims of each session are to:
• educate students about the Five Ways to Wellbeing and its
evidence base;
Acute service inpatients can access the Recovery College
courses; however, these are typically full-day courses that people
with acute mental illness may struggle to manage and access (for
example, section 17 leave).
The occupational therapy staff and Recovery College peer
tutors, therefore, began to develop ‘bite-size’ recovery courses
on the wards to provide an opportunity for patients to make a
connection with the Recovery College and start (or continue) their
recovery journey.
The Wellbeing and Therapy Team currently offers two ‘bite-size’
courses; ‘Exploring Recovery’ (a brief introduction to the concept
of recovery and importance of hope based on the Recovery
College ‘Introduction to Recovery’ course); and ‘Exploring Five
Ways to Wellbeing’, which the remainder of this article will focus
upon.
All recovery based sessions are co-delivered by a member of
staff and a peer tutor from the Recovery College (that is, a person
with lived experience of mental ill health/mental distress who is
• provide students with the opportunity to engage in a wellbeing
activity for each of the Five Ways to Wellbeing;
• facilitate peer support and generation of ideas for how to
implement the Five Ways to Wellbeing in daily life;
• promote self-management of individual wellbeing;
promote awareness of the Recovery College within the wider
ward team; and
• provide service users with the opportunity to be Recovery
College students during their admission.
Each session was one and a half hours’ duration, with further
outcomes for individual learners depending on the topic of the
session.
Experience for the service user and self
Feedback from service users has been positive, with students
valuing being with others, in terms of ‘Time spent with
people’,’Being with the group’ and ‘Peer support’.
One service user said : ‘The togetherness [was] very helpful’,
while another commented: ‘[It] helps you look at things from
different thought angles’.
Enjoyment also featured, with comments including ‘We were
learning in a fun way’ and ’I really enjoyed the course with very
good company’ as the most helpful aspects of the course.
Although this course largely met its aims, promoting awareness
of the Recovery College within the wider ward team remains a
challenge as it tended to be occupational therapy staff facilitating
the sessions.
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