Occupational therapy & mental health 

Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community and socio-economic development.

Mental health is more than the absence of mental disorders. It exists on a complex continuum, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.

Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm. People with mental health conditions are more likely to experience lower levels of mental well-being, but this is not always or necessarily the case.

As defined by the World Health Organisation 2024

Mental health difficulties can affect anyone and have a significant effect on the lives of individuals, their families, communities and wider society. 

• One in six of adults have had a common mental health disorder, such as anxiety, in the last week, according to survey data.

• Three quarters of mental health problems are established by the age of 24.

• Recent data indicates that there are close to 551,000 people in England with more severe mental illness (SMI) such as schizophrenia or bipolar disorder. This is likely to be an underestimate as figures only include those who are diagnosed and recorded on GP registers.

Predominant diagnoses are:

• Schizophrenia - disorder in the brain pathways that process language, both that which is perceived and that which is spoken. Positive symptoms include – hallucinations, delusions, disorganized speech and negative symptoms include apathy, emotional flatness 

• Bi-polar – disorder where people experience affected mood and can have periods of elation (mania) and periods of marked low mood (depression). 

• Severe depression - low mood that is present across most situations. It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause.

• Generalised anxiety disorder - is an anxiety disorder characterized by excessive, uncontrollable and often irrational worry, that is, apprehensive expectation about events or activities. This excessive worry often interferes with daily functioning.

• Personality disorder – people tend to have disturbed ways of thinking, impulsive behaviour and problems controlling their emotions. They may have intense but unstable relationships and worry about people abandoning them .  

…at times there can be a mix of diagnoses.

Occupational therapists recognise that engagement in meaningful occupation can promote good mental health, assist recovery and help people achieve personalised outcomes such as being able to care for themselves, engage in work and leisure activities, and participate within the community.

Community Mental Health Occupational therapists work within the Recovery Model. This focuses on working with individuals to regain control, support recovery, and to lead a life meaningful to them after experiencing a serious mental illness. It is not just about treating or managing their symptoms. Recovery does not always mean complete recovery from a mental health problem.

Approaches to Occupational Therapy practice in Community Mental Health settings. 

• Rehabilitative approach – Restore skills lost due to illness

• Maintenance approach – Preserve quality of life (dementia/crisis)

• Habilitative approach – Develop ages appropriate skills for first time (after bereavement taking on cooking/finance)

• Preventative approach – People with SMI increase obesity risk, type 2 diabetes and mortality rate

The following pages contain approaches and group interventions which may be used by Occupational Therapists to treat, educate, rehabilitate or enable patients to adapt, in order to maintain quality of life whilst living with a variety of mental health conditions.