Mental health

Occupational therapists facilitate recovery for those with mental health problems

Occupational therapists are recognised as one of the five key professions in health services assisting in the recovery of those with mental health problems.

• Occupational therapy is recognised as an approach that uses activity to promote good mental health, assist recovery and help people achieve personally meaningful outcomes such as employment, self care and leisure. Timely occupational therapy interventions can prevent unnecessary hospital admission, decrease the number of incidents on in-patient wards, facilitate early discharge and support adults of working age to retain their jobs during an episode of mental illness (COT 2006).
• A randomised controlled trial has shown that people with schizophrenia who receive occupational therapy interventions improve significantly more in terms of interpersonal relationships and their ability to carry out activities than those who just receive medication (Buchain et al 2003).
• A randomised controlled trial has shown that occupational therapy led lifestyle interventions that target diet, exercise, alcohol and nicotine intake significantly decrease rates of anxiety for those with panic disorder in primary care (Lambert et al 2006).
• The Care Quality Commission report into the use of the Mental Health Act in 2009/10 uses a case example from a secure ward which states that occupational therapy is the most important intervention (Care Quality Commission 2010).
• Occupational therapists contribute to the collaborative care that is recommended for those with depression and functional impairments in NICE Quality Standards and are ideally placed to meet the activities of daily living and occupation needs identified by the Mental Health Payment by Results clustering tool (CPPP 2011, NICE 2011).

Cost benefit of occupational therapy mental health services

Mental ill health is the most common reason for claiming health related benefits and the cost to employers of mental health problems among their staff is estimated to be £26 billion a year (DWP 2009, Sainsbury Centre for Mental Health 2007). Occupational therapists assisting return to work reduces the cost of claiming benefit; the value of a single person working for a full year rather than claiming benefits is nearly £20,000 for the Exchequer and over £33,000 for the economy (Oxford Economics 2007).

A randomised trial has shown that occupational therapy interventions aimed at getting people with mental health problems back into work, gets them into employment three months faster and working for significantly longer hours than standard mental health interventions. The financial benefits of service users returning to work faster and for longer hours significantly outweighs the cost of providing the occupational therapy interventions. Approximately half of those helped back into employment by occupational therapists are still in employment 42 months later (Schene et al 2007).

Adults with mental health problems who received an occupational therapy supported education programme were significantly more likely to be enrolled in an educational programme or had obtained employment six months later than those who did not receive the programme (Gutman et al 2009).

Download OT Evidence Fact Sheet - Mental Health

References

Buchain P, Vizzotto ADB, Henna Netto J, Elkis H (2003) Randomised controlled trial of occupational therapy  in patients with treatment resistant schizophrenia. Revista da Psiquiatria, 25(1), 26-30.

Care Pathways and Packages Project (2011) Mental Health Clustering Booklet Version 2. Available at www.cppconsortium.nhs.uk

Care Quality Commission (2010) Monitoring the use of the Mental Health Act in 2009/10. Available at www.cqc.org.uk

Centre for Mental Health (2010) The economic and social costs of mental health problems in 2009/10.
Available at www.centreformentalhealth.org.uk

College of Occupational Therapists (2006) Recovering Ordinary Lives. The strategy for occupational therapy in mental health services 2007-2017. COT. London.

Department of Work and Pensions (2009) Working our way to better mental health; a framework for action. The Stationary Office; Norwich.

Gutman SA, Kerner R, Zombek I, Dulek J, Ramsey CA  (2009) Supported education for adults with psychiatric disabilities: Effectiveness of an occupational therapy program. American Journal of Occupational Therapy, 63, 245-254

Lambert RA, Harvey I, Poland F (2007) A pragmatic, unblinded randomised controlled trial comparing an occupational therapy led lifestyle approach and routine GP care for panic disorder in primary care. Journal of Affective Disorders, 99, 63-71.

NICE (2011) Quality Standards for Depression in Adults.

Oxford Economics (2007) Mental health and the UK economy. Oxford: Oxford Economics.

Sainsbury Centre for Mental Health (2007) Mental health at work- developing the business case. 

Schene AH, Koeter MWJ, Kikkert MJ, Swinkels JA, McCrone P (2007) Adjuvant occupational therapy for work related major depression works: randomised trial including economic evaluation. Psychological medicine, 37(3), 351-362