FEATURE MENTAL HEALTH
Current situation puts the person at high risk of falling out at work
Marked problems with weekly routine and structure and satisfaction with weekly routine lower than 5 / 10 with no easy solution or starting point
Current problem having major impact on ability to function at work
Current problem / situation results in marked lack of engagement in leisure activities and no easy solution or starting point
What would indicate / trigger OT assessment or intervention ?
Marked problems with self care activities
• showering
• doing teeth
• getting places I need to go
Current problems are due to marked lack of living skills :
• cooking
• transport
• shopping
Marked lack of meaningful roles with poor sense of identity or purpose in life
Fgure one
There is no formal referral route , with service users benefiting from a drop-in service for initial assessment , after being signposted by their GP . Initially , service users are assessed by a community link worker to gain a broad understanding of their needs .
Link workers are then able to offer a social prescribing intervention , linking into local resources , as well as providing self-help material for a wide range of conditions .
All users of the service have the opportunity to access a timetable of wellbeing activities including yoga , Tai Chi and mindfulness , as well as short workshopbased interventions , including wellbeing workshops and a Good Sleep programme .
In addition to these wellbeing activities , the clinical team also offers therapeutic group-based interventions targeting the development of coping strategies , resilience building , an awareness of mental wellbeing and factors that positively influence this .
The majority of service users will only access the community link worker aspect of the service , with a smaller percentage of individuals with more complex needs requiring input from the clinical team .
Occupational therapy contribution to the hubs As a new service , occupational therapists were able to take time to develop processes and think about how occupational therapy could add value to the development of the community wellbeing hubs by making occupation a central point in occupational therapy interventions .
Initially , the occupational therapists facilitated a session at a team development day explaining the role of occupational therapy and introduced some referral indicators to allow the multidisciplinary team to develop an understanding of what could prompt a referral to occupational therapy ( see figure one ).
There was a need to distinguish between the community link worker and occupational therapy role . The indicators encouraged the team to think about the marked impact on function and the severity on a service user ’ s ability to engage in occupations .
Low motivation to access social prescribing opportunities was also identified as an opportunity for occupational therapy assessment and goal setting , to enable the service users to access local resources with assistance from community link workers .
The occupational therapists felt it important to reflect occupation in the language and introduced interventions as either occupation based or occupation focused .
A wellbeing plan was introduced by occupational therapy , which enables goals to be documented and tracked across the service .
The occupational therapists were keen to develop occupation focused therapeutic groups for anxiety management and confidence building , and also trialled an occupation-based group with a local community gardening project , to offer service users the opportunity to enjoy nature in a more structured way , practise social skills and experience the occupation of volunteering in a more supported environment .
Considering the short-term nature of service user involvement , they were keen to introduce some stand-
30 OTnews December 2020