My final placement and first year post-qualifying were spent on acute inpatient mental health wards, so the question of whether OTs are responsible for activity provision is a very familiar one. Thank you to Peter (@ihealthE1) and Lisa (@OT_LisaB) for agreeing to host an #OTalk about how they raise the profile of activity on their wards, whilst balancing the need for individual assessment and discharge preparation. I’ll be travelling back on a train at the time of the chat, so may not be able to participate in the chat (signal-dependent!). Thank you to Kirsty (@kirstyes) for supporting Lisa and Peter in my absence.
You might like to check out one of our previous #OTalks: “Occupational Therapy and Groupwork“, hosted by @ClaireOT. Another linked chat, an on the topic of boredom, includes resources such as a powerpoint presentation by Karen Newberry entitled “Bored on the ward: is it the occupational therapists problem?”
As usual, the chat will take place on Twitter using the #OTalk hashtag at 8pm GMT (click the link to find out your local time). If you’re new to tweetchats, check out our guide for participants and contact me (@geekyOT) if you need any extra help getting to grips with #OTalk.
ADDITION: Peter and Lisa have kindly agreed to share the PDF version of their conference poster.
Raising the Profile of Activity in Acute Mental Health
Peter Walton and Lisa Brown are part of an occupational therapy team covering two acute inpatient mental health units in the urban conurbation of Manchester. They presented a poster entitled ‘”I’m Bored!” – raising the profile of activity in acute mental health’ at the College of Occupational Therapists conference in 2014 and were invited to host this #OTalk after this.
Recent clinical guidance recommends that “service users in hospital have access to a wide range of meaningful and culturally appropriate occupations and activities … These should include creative and leisure activities, exercise, self-care and community access activities” (NICE 2011 p22). Traditionally, Occupational therapists have been perceived to be responsible for the provision of all activities on acute mental health wards (Robinson and Avallone 1990). More recently, inpatient occupational therapists’ work has become primarily discharge-focused assessment and treatment planning on a one-to-one basis. This results in a lack of provision of group and recreational activity that is valued by service users (Radcliffe and Smith 2007) such that “the level of activity of users of acute inpatient services is alarmingly low” (Killaspy et al 2013 p2).
The OT’s in our team promote a culture of activity in the ward environment without taking sole responsibility for delivery. We record activity provision across the wards and produce visual displays of the findings with the aim of influencing staff motivation and levels of activity in the ward environment.
This #OTalk will encourage discussion and debate around the role and strategies of the occupational therapist in influencing ward activities in mental health.
Some questions to consider prior to the chat:
Is it the responsibility of occupational therapists to provide / be responsible for the activity available on acute psychiatric wards?
How do we encourage MDT involvement in the provision of ward activities?
How do you balance group work on acute mental health wards with pressure for discharge assessments?
How far is ward activity provision and promotion part of the job description for an acute mental health OT?
Antonysamy A (2013) How can we reduce violence and aggression in psychiatric inpatient units? BMJ Quality Improvement Report, 2013 (2). doi:10.1136/bmjquality.u201366.w834
Care Quality Commission (2010) Monitoring the use of the Mental Health Act in 2009/10. London: Care Quality Commission. Available at: http://www.cqc.org.uk/sites/default/files/media/documents/cqc_overview_of_monitoring_the_use_of_the_mental_health_act_tagged.pdf Accessed on 23.04.14.
Mental Health Act Commission (2009) Coercion and Consent: Monitoring the Mental Health Act 2007-2009. London: Stationery Office. Available at: http://www.cqc.org.uk/sites/default/files/media/documents/mhac_biennial_report_0709_final.pdf Accessed on 23.04.14.
NICE (2011) Service user experience in adult mental health: Improving the experience of care for people using adult NHS mental health services. National clinical guideline 136. London: NICE. Available at: http://www.nice.org.uk/nicemedia/live/13629/57534/57534.pdf Accessed on 23.04.2014.
Thank you to everyone who participated, and welcome to all our new tweeters!