Other OT-Related Information Occupational therapy mental health

[InfoNerd101]

Why is occupational therapy losing its foothold as a "recognized mental health profession?" What can or is going to be done to fix this?

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[aluan150]

• I know that at Skilled Nursing Facilities and while most of the patients are physically unstable , a lot of them are treated for their mental cognitive disabilities as well. OT therapies for those kind of patients will be designed to develop the patient's assertiveness; cognition (e.g., problem solving); independent living including using community resources, home management and time management plus management of their pain medications for example. The origins of occupational therapy are rooted in mental health, as the creation of the profession dovetailed with the early 20th century's mental hygiene movement. And as per AOTA :

• Occupational therapists and occupational therapy assistants working in the area of community mental health are employed by or provide consultation to:

• • adult day care centers,
  • day treatment centers,
  • home health agencies,
  • community rehabilitation programs,
  • community mental health clinics,
  • clubhouse programs,
  • outpatient psychiatric clinics,
  • foster care residents,
  • sheltered workshops,
  • group and private homes,
  • community support programs.
  So I don't see them losing foothold anywhere. It may not be just so open and specific as most patients who come to see OTs start with issues of independence and mobility. Good OTs are holistic in their approach. That is ,while they may work with a patient to gain some physical independence in their old age , they also will work with them to help them regain their inner confidence by using appropriate therapeutic modules entwined in their treatments.

 

[c0ffeel0ver]

@InfoNerd101

I feel the same way as well. I believe it is because there are many people with mood disorders (depression, bipolar) and anxiety disorders (phobia, PTSD, OCD) but not enough OTs that are in that are focused in the mental health setting. Also it is tough to treat a person with mood disorders because the condition varies with each person and there is no cure or specific treatment to help them. I know there is a research on the OTs role with depression and the study shows that getting the client active in an activity they used to enjoy will help increase their serotonin levels but the toughest part of helping the patient is motivating them. Also a lot of people with mood disorders do not like taking medication (because of the side effects and sometimes they have no motivation to take them). Not taking medication can either make the therapy session more difficult and it can limit what the OT can do with the client.

Another issue is in the mental health setting in general. It takes a VERY VERY Long time to get an evaluation and services. Also these conditions can't be fixed within a couple sessions. It may take years and years of therapy to help a person with a mental illness which means the therapy sessions will cost the patient A LOT of money.

The only way to tackle this problem is bringing awareness to this issue and more research. The mental health has the negative stigma in our society and a lot of people believe that having depression, OCD, or any mental health condition is something that someone can "just deal with" or "get over". Because of the negative stigma, a lot of people don't seek for help and the condition progressively gets worse. To help increase awareness and services to the mental health, we need more research to solidify the OT's role in the client's medical care. OTs only get paid if they are able to back up their services with evidence based research (because OTs can't get paid for their services if they don't have proof that OT works to the insurance companies).

OT is a demanding field and maybe one day OTs will be required to have a doctorate. So, don't lose hope, it just takes time and a lot of patience to tackle a huge issue.

 

[Gemut]

Statisitically speaking, OT practice has significantly diminished within the mental health field since OT was founded a century ago. OT began as a practice almost exclusively focused on mental health, even its roots can be traced to the moral treatment movement ushered in by the physician Pinel in France and the Quaker Tuke in England. Only about 2% of OT's specialize in this area of practice today. While it is so that OT's are somewhat prepared to practice in mental health, it is a relatively under represented area of expertise for a number of reasons.

OT practice has been a very fluid and oportunistic realm. With the physical disabilities of soldiers in WW I & II came a greater focus on phys dis. With the establishment of medicare in the mid sixties, which officially recognized OT in geriatric practice, more OT's entered treatment of older adults. With the establishment of the Individuals with Disabilities in Eduacation Act (IDEA) there came a migration of OT's into pediatric practice. Each of these opportunities came with funding and employment that made it possible for OT's to specialize in one of these areas.

While these developments occured, employment opportunities for OT's in state funded mental health settings began to drop as states began to reduce the population of institutions that focused on mental health. This drop in state funding precipitated a commensurate drop in OT mental health practitioners to about 2% of the field. Meanwhile, the practice of mental health by Psychologists, MFT's, & LCSW's began to solidify and expand into areas once the purview of OT's. Art Therapy, for example, is a specialty within the MFT field. Each of the aforementioned mental health practitioners has a much stronger professional organization than OT's and has protected its turf in statutory skirmishes at the state and federal levels. At the same time, OT's were not officially recognized through licensing procedures in all 50 states until 2014! In a nutshell, while OT was busy expanding beyond its initial specialty of OT, other specialties suplanted OT as a primary mental health provider. This is best exemplified by the fact that the ACA requires mental health coverage to be provided to all those with insurance under Obamacare, but OT's are not considered primary mental health care providers like PsyD's , MFT's, or LCSW's.

This is a complex and complicated inquiry. The bottom line is OT's practice in mental health at the pleasure of those practioners who diagnose mental health clients and refer them for OT. As long as Psychologists, Psychaiatrists, MFT's, & LCSW's recognize and value the contribution occupational therapy in the treatment of those diagnosed with mental health conditions, there will be a place for OT in mental health. It is up to occupational therapists and their professional organizations to promote and make visible the contribution and efficacy of OT in the practice of mental health so its role in this field can expand beyond its current level.

 

[hGmatureapp]

I think that OT in mental health does not have a clear protocol

they still rely on being a therapist as an art which is increasingly difficult in this day and age where everything has to be quantifiable and measurable