Occupational Therapy in Mental Health | Overview & Updates

Did you know that occupational therapy practitioners (OTPs) play a role in mental health and work in mental health settings? While OTPs are known to work in pediatric settings and physical rehabilitation, a lot of occupational therapy’s history is rooted in mental health practice! Learn about trends in OT mental health practice, settings where OTPs in mental health work, interventions provided, effectiveness, and related information.

History of Occupational Therapy in Mental Health

The profession of occupational therapy itself has a rich history influenced by historical events and movements – from wars to economic shifts to health care legislation to technologies and civil rights movements for children, women, and mental health.

Moral treatment was often associated with mental illness.and spread to the united states with themes of opportunity, participation, and dignity. This movement was based on the idea that those with psychiatric disorders to be treated humanely with regard to their environment as well as actual treatment. Interventions for those with mental illness saw a shift to promote the use of arts and crafts and curative occupations. This new movement was a reaction to the industrialization and modernization of society in the 1900s.[1]Christiansen, C. H., & Haertl, K. (2014). A contextual history of occupational therapy. Willard and Spackman’s occupational therapy, 9-34.

Occupational therapy was considered to be one of the most valued services for people with mental health disorders in the period of World War I and II, such as wounded soldiers and for those with psychiatric disorders.

A Decrease in Occupational Therapy Practice in Mental Health

However, one reason why occupational therapy may not be as well known for mental health services these days compared to other professionals such as psychologists, psychiatrists, counselors, and LMFTs may be due to societal factors, insurance, legislators, and lobbying.[2]Gutman, S. A. (2011). Effectiveness of occupational therapy services in mental health practice. AJOT: American Journal of Occupational Therapy, 65(3), 235-238.

“Since its beginnings, occupational therapy has promoted mental health through engagement in meaningful occupations. As service delivery and payment models have evolved, the profession has seen fewer opportunities to provide services to those with behavioral health challenges. AOTA is working to increase access to occupational therapy services for people with serious mental illness, substance use disorder, and other behavioral health needs.”[3]AOTA.org

Settings

  • Acute care hospital
  • Outpatient
  • State hospital
  • Skilled nursing facilities
  • Assisted living
  • Home health
  • Community centers[4]Beltran, R.O., Scanlan, J. N., Hancock, N., and Luckett, T. (2006). The effect of first year mental health fieldwork on attitudes of occupational therapy students towards people with mental illness. … Reference List[5]Hector W. H. Tsang; Fong Chan, and Chetwyn C. H. Chan (2004). Factors influencing occupational therapy student’s attitudes toward persons with disabilities: A conjoint analysis. American Journal of … Reference List

Interventions

Examples of modern evidence-based interventions that occupational therapy practitioners in mental health provide include:

  • Employment
  • Education
  • Psychoeducation
  • Creative activities
  • Time use or occupational balance
  • Skills and habit development
  • Group and family approaches
  • Animal-assisted therapy[6]Kirsh, B., Martin, L., Hultqvist, J., & Eklund, M. (2019). Occupational therapy interventions in mental health: A literature review in search of evidence. Occupational Therapy in Mental Health, … Reference List

Effectiveness

Occupational therapy interventions in mental health are often delivered in a group format. Clients in groups can undergo a unique therapeutic learning process in that can promote skills, self-esteem, a sense of belonging, and a unique experience with their peers.[7]Zedel, J., & Chen, S. P. (2021). Client’s experiences of occupational therapy group interventions in mental health settings: A meta-ethnography. Occupational Therapy in Mental Health, 37(3), … Reference List

Many studies have been published evaluating the effectiveness of occupational therapy interventions aimed at improving the performance and well-being for people with mental health conditions. A study of 11 randomized controlled trials totaling 520 adults with mental health diagnoses found that occupational therapy interventions (see above) may be effective in improving these goals. The authors conclude that occupational therapy plays an integral part of the rehabilitation services in mental health.[8]kiugu, M. N., Nissen, R. M., Bellar, C., Maassen, A., & Van Peursem, K. (2017). Clinical effectiveness of occupational therapy in mental health: A meta-analysis. The American Journal of … Reference List

What’s Happening in Mental Health for Occupational Therapy?

Congress Shows it Values Occupational Therapy’s Role in Mental Health

On October 26, the House Energy & Commerce Subcommittee on Health held a legislative hearing on seven bills related to supporting patients, caregivers, and providers. Dr. Victoria Garcia Wilburn, DHSc, OTR, FAOTA, a member of the AOTA Board of Directors, testified at this hearing in support of H.R. 3320, the Allied Health Workforce Diversity Act. The same hearing also saw H.R. 5583, the Helping Enable Access to Lifesaving Services (HEALS) Act come up for debate.

The HEALS Act would reauthorize several programs intended on strengthening the health care workforce, including the Behavioral Health Workforce Education and Training Program (BHWET). [Continue Reading]

  • The Colorado (CO) state OT practice act was renewed (January 2021) with modernized language; this included intentionally adding terminology related to mental health practice and removing binary language from the statute and rules and regulations.
  • The State of CO is adding forensic treatment beds to one of the state hospitals, expanding inpatient treatment for this adult population.
  • The CO Department of Human Services is transforming CO’s behavioral health system intending to form a Behavioral Health Administration (BHA) that will partner with state agencies to ensure equitable access to mental health and substance use care for all Coloradoans. The General Assembly is currently in session, and the Occupational Therapy Association of CO (OTAC)’s legislative committee and lobbyists monitor BHA bills and others that may impact occupational therapists and the profession.
  • In Indiana, occupational therapists, OTAs, and researchers are pushing hard for more access to OT services for those in recovery, as highlighted in a recent AJOT piece on the status of occupational therapists and OTAs as mental health professionals in that state.[9]Gee, B. M., Zimmerman, S., Hinds, J., & Read, H. (2022). A Dialogue Regarding the Current Status of Mental Health and Occupational Therapy Practice in the United States. The Open Journal of … Reference List

Optimism

Many occupational therapy practitioners are optimistic about mental health practice for occupational therapy in the United States. There is a gradual expansion of OT practice in mental health settings with specific roles. Through the use of evidence-based practice and the unique occupational therapy perspective, occupational therapy can empower clients to do more and live better lives.[10]Gee, B. M., Zimmerman, S., Hinds, J., & Read, H. (2022). A Dialogue Regarding the Current Status of Mental Health and Occupational Therapy Practice in the United States. The Open Journal of … Reference List

References

References
1 Christiansen, C. H., & Haertl, K. (2014). A contextual history of occupational therapy. Willard and Spackman’s occupational therapy, 9-34.
2 Gutman, S. A. (2011). Effectiveness of occupational therapy services in mental health practice. AJOT: American Journal of Occupational Therapy, 65(3), 235-238.
3 AOTA.org
4 Beltran, R.O., Scanlan, J. N., Hancock, N., and Luckett, T. (2006). The effect of first year mental health fieldwork on attitudes of occupational therapy students towards people with mental illness. Australian Occupational Therapy Journal. 54 (1). DOI: 10.1111/j.1440-1630.2006.00619.x
5 Hector W. H. Tsang; Fong Chan, and Chetwyn C. H. Chan (2004). Factors influencing occupational therapy student’s attitudes toward persons with disabilities: A conjoint analysis. American Journal of Occupational Therapy. July/Aug. Vol. 58, 426-434.
6 Kirsh, B., Martin, L., Hultqvist, J., & Eklund, M. (2019). Occupational therapy interventions in mental health: A literature review in search of evidence. Occupational Therapy in Mental Health, 35(2), 109-156.
7 Zedel, J., & Chen, S. P. (2021). Client’s experiences of occupational therapy group interventions in mental health settings: A meta-ethnography. Occupational Therapy in Mental Health, 37(3), 278-302.
8 kiugu, M. N., Nissen, R. M., Bellar, C., Maassen, A., & Van Peursem, K. (2017). Clinical effectiveness of occupational therapy in mental health: A meta-analysis. The American Journal of Occupational Therapy, 71(5), 7105100020p1-7105100020p10.
9, 10 Gee, B. M., Zimmerman, S., Hinds, J., & Read, H. (2022). A Dialogue Regarding the Current Status of Mental Health and Occupational Therapy Practice in the United States. The Open Journal of Occupational Therapy, 10(3), 1-9.
Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.