MENTAL HEALTH FEATURE alone workshops that any hub service user could attend , to fit alongside some of the wellbeing activities , including a two session ‘ Introduction to wellbeing ’ workshop .
Demonstrating the impact To demonstrate the impact and contribution of occupational therapy we were keen to monitor and evaluate outcomes .
During the first six months of this new service opening , 94 people were identified as suitable for occupational therapy assessment . The majority of these individuals were offered individual interventions , as they were still in the planning phase of the group-based programme , however , 25 service users accessed the newly-developed group based interventions .
The main outcome measure being used is the Canadian Occupational Performance Measure ( COPM ), an individualised measure that can be used to identify and prioritise occupational performance areas , as well as a goal setting tool ( Law et al 2014 ). The COPM is used as our initial assessment tool to gain a baseline score , as well as at the end of intervention to measure outcome on intervention . Any change in score over two represents a clinically-significant change .
Of the service users who completed intervention with the occupational therapists , the average change in performance and satisfaction scores did demonstrate positive outcomes in our initial phase of service roll out .
As well as outcome measures , qualitative data via end of intervention questionnaires was gathered .
One man who attended the occupation-focused anxiety management group stated at the end of the intervention : ‘ I cannot express how many positives I have gained through [ attending the hubs ]. It ’ s been an incredibly valuable and much-needed support mechanism you are providing for such a large demographic . I have come away with improved confidence , a willingness to try new things , to challenge my well established thoughts , to tweak my dayto-day routine and to proactively engage in more flow activities .’
The occupational therapists were keen to evaluate the areas of focus for occupational therapy intervention , with the highest frequency being interventions focused on developing routine and structure and work and education , and interventions focused on developing independent living skills the lowest .
Challenges and plans for the future Going forward , we are now in a position to consolidate what we have learnt and focus on continuing to deliver a high quality intervention .
The challenge we will face will be how we meet the needs of a high volume , high turnover service , with the limitation of having only two occupational therapists in the team .
We are looking at how we expand the group-based interventions offered to meet this demand , exploring more needs-led groups , including supporting our service users in coping with transitioning through the COVID-19 pandemic , as well as the challenge of delivering a community-based service in the current climate .
Atler and Fox ( 2020 ) conducted a qualitative descriptive study to examine the utility of an occupation-focussed assessment to guide engagement in meaningful activity . Eight individuals accessing a community mental health centre in the US used the Daily Experiences of Pleasure , Productivity and Restoration Profile to set and work towards goals . Multiple data gathering procedures were employed . Three themes emerged : completion of the profile was ‘ burdensome , but right on ’; moving from insights gained to choosing and working towards a goal required guidance from the therapist ; and insights gained from the profile supported some changes in action and / or perspectives . The authors identify the study provides preliminary evidence regarding perceived utility of the Profile , and contributes to understanding of the role of occupation-focused assessment in the area of occupational therapy and mental health .
Reference Atler KE and Fox AL ( 2020 ) Mental health consumers ’ perspectives on using an occupationfocussed assessment to initiate change in everyday activities . British Journal of Occupational Therapy , Oct 12 . [ Epub ahead of print ]
References
Law M , Baptiste S , Carswell A , et al . ( 2014 ) Canadian Occupational Performance Measure ( 5th ed ) Ottawa : CAOT Publications ACE Royal College of Occupational Therapists ( 2016 ) Improving Lives , Saving Money campaign . Available online at : www . rcot . co . uk / promotingoccupational-therapy / occupational-therapy-improving-lives-savingmoney [ accessed 27 November 2020 ] Scottish Government ( 2018 ) Better mental health in Scotland .
Inga Davidson , specialist occupational therapist , and Kathrin Crawshaw-Zein , specialist occupational therapist , Boghall Community Wellbeing Hub . Email : Inga . Davidson @ nhslothian . scot . nhs . uk
EVIDENCE LINK
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