Across the Board: Mental Health in Every OT Context

By: Lily Harrington, COTA

You know the saying: “Once a mental health OT, Always a mental health OT”. Okay, maybe that one isn’t as popular as I think it is, but I’ve found it to be true. Recently, I made the transition from working in mental health to taking a job in travel OT. It was a difficult decision to make due to my love for the context of mental health, but was something I had to do to grow as a person. Between you and me, I’d argue this change has almost made me a better mental health professional.

If you’re an OT practitioner working in mental health, or even an OT student, you know that mental health is a blip on the map in your college years. Instead, your experience involved learning adaptive dressing techniques, battling eye strain learning how to read a goniometer, and questioning whether the palmar supinate grasp comes before or after the quadrupod grasp. The information overload is immense, and it comes as no surprise that any mental health related information is almost impossible to recollect. In all honesty, when I first arrived at my placement, mental health was in the back of my mind as I scrambled to remember safe transfers, hip precautions and neuro-reeducation skills. When I fell into my groove, though, the mental health OTA who was temporarily pushed back was brought forth once more.

I believe that OT practitioners who are familiar with or have a passion for mental health bring a unique perspective to treatment that can greatly increase our patient’s treatment outcomes. We are tuned to notice the subtle glance at the clock or the change in affect. In a setting such as subacute rehab where the focus is primarily on the acuity of the physical condition, we dig deeper and notice the mental component plays as important of a role, if not more, than the physical. In fact, “24% of patients identified as depressed after surgery while 40% identified as anxious” (Namnoum, 2021). We know how imperative the mind body connection is, and that depression, anxiety or any mental health issue can increase morbidity.

So, how do we combine the treatment of physical dysfunction and mental health? It begins by peeking behind the spooky precautions and procedures and at the person. As OT practitioners, we have a knack for this. Alongside treating the physical manifestation of illness, we can work with the client to help heal the mind as well. This can look like:

● Setting realistic small term goals that involve activities meaningful to the client

● Creating healthy routines that provide structure, motivation, and meaningful, fulfilling activities

● Empowering clients with coping skills to manage pain, anxiety or depression.

● Cultivating a unique sensory profile that can help promote self-regulation and reduce response to stressing stimuli

● Mindfulness meditation, which has been proven to be an effective tool for pain management

● Cultivating inter-personal social skills to increase a client’s ability to advocate for themselves and communicate their needs/wants to other medical professionals

● Educating and advocating for your client’s mental health to be included in their plan of care

● Utilizing sensory soothing lighting, sounds, tones, etc. during treatment (or, reversely, using sensory stimulating environments to increase engagement in treatment sessions)

Those of us who have worked with more serious mental illnesses are also well-equipped to deal with acute co-occurring disorders. For example, we could have the skill set to communicate effectively with an individual experiencing delusions or hallucinations, or know de-escalating techniques to promote self-regulation when clients are experiencing an escalating event. Knowing these skills while addressing the physical portion of a treatment session can produce an encouraging, fulfilling session.

As OT practitioners, we’ll find mental health in all of the contexts we work in. It is imperative to familiarize ourselves with mental health across multiple contexts, and it can start with you. Taking time to ask our clients how they’re feeling mentally alongside the other evaluation questions, communicating with other professionals on how to best support your client mentally as well as physically, and staying up to date on mental health in acute care. Healing is a whole body process, and Occupational Therapy practitioners can be one of the few people who can be the deciding factor in quality of care, and in turn, quality of life.

References

Namnoum, J. (2021, March 19). Depression after surgery: Symptoms, causes, and how to Cope. James D. Namnoum M.D., FACS. Retrieved February 13, 2022

Su, I.-W., Wu, F.-W., Liang, K.-C., Cheng, K.-Y., Hsieh, S.-T., Sun, W.-Z., & Chou, T.-L. (2016, November 10). Pain perception can be modulated by mindfulness training: A resting-state fmri study. Frontiers in human neuroscience. Retrieved February 13, 2022

Moving With Hope. (2021, May 1). Occupational therapists and mental health interventions. Moving With Hope. Retrieved February 13, 2022