Reintegrating occupational therapy in community mental health: a pilot program
Current community-based mental health services in the state of Florida are sparse and focused on targeted areas, such as medication management, psychiatric services, trauma-based support groups, and day programming. Few programs or services facilitate community re-integration, and those that do, rely mainly on peer support services. The current continuum of care is not always able to account for the far-reaching effects of mental health and substance abuse issues and how they create obstacles to daily living and community participation. In Florida, mental health, substance abuse, and co-occurring disorder programs are under strain from a lack of funding. According to the State of Florida Appropriations Committee 2021 Annual Budget, only 7% of the allotted 3.8 billion dollars of funding to the Department of Children and Families is designated for community mental health and substance abuse services (The Florida Senate, 2022). These funds must stretch across all the programs and other related services. Funding for occupational therapy services is largely non-existent in these programs, despite a long history of treating this population. Occupational therapists (OTs) receive specialized education and clinical training to address areas within the continuum of community reintegration for clients experiencing mental health and co-occurring disorders. OTs can apply theory and conceptual models of practice stemming from a rich occupational science history to enable successful improvements in occupational participation and performance.
Everyone has experienced having to power through the day after a night of not sleeping well with every aspect of the day feeling more challenging due to your lack of sleep. The National Institute of Health (2017) identifies sleep as one of the most important occupations for maintaining all aspects of health. In fact, the Centers for Disease Control and Prevention (2018) has recognized sleep deprivation as a public health problem with broad, negative effects on safe occupational performance. For the older adults the challenges brought on by age compounded with a lack of sleep can further decrease successful occupational performance. Many age-related changes tend to disturb patterns of sleep and the myth that older adults need less sleep is actually incorrect (Suni, 2022b). The older adult is confronted with additional sleep obstacles such as, chronic conditions, medications, diminished physical activity, and decreased cognitive exercise, all of which have all been associated with decreases in sleep satisfaction. The resulting downward spiral of poor sleep results in less successful occupational engagement. The Occupational Therapy Practice Framework includes ‘rest and sleep’ as an area of occupation and defining occupational therapy practitioners as qualified professionals to assist clients with the occupation of rest and sleep (American Occupational Therapy Association, 2020). This brief article seeks to assist practitioners with identifying resources and awareness for more consistently addressing the occupation of sleep in the older adults.
