Sharon A. Gutman, Emily I. Raphael-Greenfield; Five Years of Mental Health Research in the American Journal of Occupational Therapy, 2009–2013. Am J Occup Ther 2014;68(1):e21-e36. doi: 10.5014/ajot.2014.010249.
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© 2019 American Occupational Therapy Association
In the past 5 years, the number of research articles on occupational therapy in mental health published in the American Journal of Occupational Therapy has steadily declined. This article identifies the strengths and limitations of this body of research and provides directions for practitioners and researchers to enhance the profession’s role as a valued mental health service provider.
All diagnoses that have been labeled as physical disabilities or illnesses have an emotional health component that is frequently unaddressed in the current health care and education systems. Educators must begin to teach students to identify and address the emotional health components of physical disabilities. Practitioners must seek ways to address clients’ psychosocial concerns that accompany physical disability diagnoses. Researchers must conduct studies that document intervention outcomes equally addressing both emotional and physical health.
A large percentage of children and youth in the school system have psychosocial deficits or behavioral management problems, engage in substance use, and are at risk for school drop-out. Traditional school-based therapy must expand to address the psychosocial needs of children, youth, and parents. Researchers must examine how psychosocial problems affect school participation and conduct intervention studies that support the effectiveness of psychosocial occupational therapy services for children, youth, and families.
An array of groups need transition services as they age out of care (e.g., young adults with autism spectrum disorders, developmental delay, learning disabilities, intellectual disabilities, traumatic brain injury, or mental health disabilities and foster care recipients). Occupational therapy practitioners often provide services to these groups in childhood but must begin to advocate for transition services to help these clients to, when young adults, secure supported employment, education, and residential living. Researchers must document the effectiveness of occupational therapy transition services for these groups.
A high percentage of older adults experience depression and suicidal ideation; this percentage increases for those residing in nursing homes and assisted care facilities (National Institute of Mental Health, 2010). Although occupational therapy practitioners have traditionally provided this population with self-care and ADL assistance, the profession has not adequately addressed the evaluation and treatment of depression, despite training and availability of service reimbursement. Practitioners have a responsibility to better identify and treat depression in older adult clients, and researchers must become more involved in the generation of studies that assess occupational therapy intervention effectiveness in this area.
Epidemic rates of homelessness now affect single adults, families, and children (National Coalition for the Homeless, 2009). Occupational therapy practitioners can help these populations learn the skills needed to transition from a shelter and maintain independent or supported residential housing. Children who are homeless need assistance to attain developmental, emotional, and sensorimotor skills. Research is needed to identify factors that aid individual and family transition to supported and sustained housing.
Returning veterans and their families are challenged by posttraumatic stress disorder, depression, anxiety, adjustment disorder, and substance use. The psychosocial challenges accompanying head injury, amputation, and spinal cord injury, although often overlooked, complicate the course of rehabilitation and adjustment and must be addressed to prevent further disability and role loss. Occupational therapy practitioners within and outside of the military must advocate for an expanded role beyond traditional rehabilitation service provision and help veterans to seek help despite fears of discrimination.
People who have experienced natural disaster or terrorism need help adjusting to the trauma and rebuilding roles and daily life occupations. An unfortunate reality of our current society is that occupational therapy practitioners could be of great benefit to those needing to rebuild lives after such losses, upheaval, and violence. It would be unethical for the profession to withhold its skills in these circumstances because of a lack of funding. In such circumstances, as in many of those previously described, we may need to first demonstrate our proficiency and contribution before occupational therapy positions are routinely created. Such demonstration may be achieved through community volunteerism and student service learning opportunities supervised by faculty. Educators who have the responsibility of exposing students to emergent practice areas may be best positioned to lay the groundwork for occupational therapy practice expansion in many of the preceding areas.
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