FEATURE MENTAL HEALTH
have been putting off , such as taking the dog for his booster ’; [ From the case-record ] ‘ One service user reported that she has developed a tick list for bills to pay , emails to send , and people to speak to ’.
See friends : ‘ I completed a 40 minute Wii workout with my friend and had fun ’; ‘ I have made contact with my best friend of 20 years , as I am now free to do so ’; and ‘ I have started meeting my friends during the day , to go shopping and have lunch ’.
Have the confidence to get out : ‘ Guess what I did last week ? I took the dog for a five-minute walk ’; ‘ I spent 20 minutes in a neighbour ’ s garden , talking to her ’; and ‘ I went for a coffee on my own in the village at the weekend , it was lovely ’.
Quality of life The combined effect of managing everyday activities improved overall satisfaction with performance , while several people commented about experiencing an overall improvement in quality of life : ‘ I am loving my new life ’; ‘ I am really grateful for all the support ’; ‘ I am beginning to feel more like my old self ’; and ‘ Where previously I was unable to take part in meaningful activities , I am now engaging ’.
Saving costs to the economy Research suggests that , on average , a person living with domestic abuse experiences the cycle of violence 36 times , while exiting and re-establishing the relationship seven times before the relationship is finally over . This is catastrophic to employment , housing needs , health service and the legal system , resulting in costs to the economy being around £ 34,015 per victim per year ( Oliver et al 2019 ).
The cost to the economy associated with the health costs of addressing emotional harms and lost output alone range between £ 3,610 and £ 308,510 per victim per year , depending on the severity of the abuse , extent of harms , and the level of earnings of the individual .
Consequently , providing upstream early intervention and therapy to support return to daily activities , such as work , and improving emotional wellbeing and resilience will have a significant impact .
Further detail on cost savings to the economy , in line with Prudent Principles , can be found at : www . bevancommission . org / post / domestic-abuseoccupational-therapy-daot-a-project-in-response-tocovid-19 .
Next steps While the project has been successful in its first year , we are exploring further funding streams to continue and expand the project across BCUHB and Wales , with the occupational therapy service providing clinical governance and acting in partnership with domestic abuse service providers , such as DASU .
We are currently developing an education pack for occupational therapists , a training resource to support occupational therapists in other fields when working with domestic abuse patients / clients , and a BCUHB domestic abuse service specification .
We have successfully launched our Bevan Commission webpage ( Clarke and Jones 2021 ) and attended a Bevan Commission showcase event , in June 2021 , which was seen by the Minister for Health , commissioners and Senedd Members . We also presented at the AHP Bevan Exemplar event in September
New directions include exploring the Bevan Commission ‘ adopt and spread ’ Wales programme , continuing our work with DASU and the Department of Working Pensions ( DWP ) to pursue additional funding , and to continue to influence and educate partner organisations and multidisciplinary and agency colleagues on the role of the domestic abuse occupational therapist .
Our Bevan Exemplar experience has been fascinating and all-consuming , and it has been a steep learning curve to deliver this project . The Bevan Exemplar education programme has been supportive , and I would recommend the programme to anyone developing a prudent innovation within the NHS in Wales .
References
Clarke L and Jones K ( 2021 ) Domestic abuse occupational therapy : A project in response to COVID-19 . [ online ] Available at : www . bevancommission . org / post / domesticabuse-occupational-therapy-daot-a-project-in-responseto-covid-19 > [ accessed 3 July 2021 ]
Jones K ( 2020 ) Bridging the gap , Occupational Therapy News , 28:8 : 54-55
Oliver R , Alexander B , Roe S and Wlasny M ( 2019 ) The economic and social costs of domestic abuse . UK Home Office . [ online ] Available at : https :// assets . publishing . service . gov . uk / government / uploads / system / uploads / attachment _ data / file / 918897 / horr107 . pdf [ accessed 3 July 2021 ]
Lucy Clarke , clinical lead occupational therapist , and Kim Jones , occupational therapist , Betsi Cadwaladr University Health Board , email :
Lucy . Clarke2 @ wales . nhs . uk or
Kim . Jonesa5d87 @ wales . nhs . uk . With thanks to the Elizabeth Casson Trust and Betsi Cadwaladr University Health Board for the funding opportunity
20 OTnews October 2021