The OT Journal Club

-Journal Club (JC) host-  Abigail Brown - Specialist Mental Health Occupational Therapist (UK), providing inpatient rehabilitation.

-Research title-  The role of occupational therapists in acute mental health inpatient settings: A systematic scoping review

-Research authors-  Adelle, A., Bedford, K., McMahon, S., Dun, C., Starbuck, R. and Doroud, N.

-Journal of publication-  Australian Occupational Therapy Journal

-Publication date-  10th June 2025

>> A link to the full article can be found at the end of this JC

-Background-

In inpatient mental health settings, occupational therapy (OT) aims to maximise independence, promote recovery and transition people back into their community. The unique contribution of OT interventions relates to meaningful activities, offering choice and enabling a sense of normality and belonging in patients' lives.

-Method-

A scoping review, of 21 studies, was used to explore the evidence for occupational therapy interventions within acute mental health inpatient settings.

-Implications-

Five main themes:

1. How patients feel about occupational therapy

2. Helping patients do daily activities and make choices

3. Helping patients improve daily living skills

4. Reducing the use of strict rules and locked areas

5. Using sensory tools to manage stress

These themes link to inpatient spaces and how occupational therapists work to support recovery through developing skills and building confidence in abilities. Therapists support with developing routine, stress management, relapse prevention and social inclusion.

Findings highlight the vital role of occupational therapists in acute inpatient mental health settings, in:-

• addressing occupational deprivation and functional decline

• reducing the need for restrictive practices

• enabling self‐management strategies, to reduce distress

-Key points for Occupational Therapy -

• OT interventions offer a positive experience for consumers in acute mental health inpatient settings.

• Occupational therapists enable consumers' activity engagement, choice and functioning in acute mental health inpatient settings

• Use of sensory modalities can reduce the need for restrictive practices

-Future studies should look at...-

• How well occupational therapy works in acute mental health wards

• What gets in the way of using occupational therapy in this setting

• How patients feel it helps their recovery

-Limitations-

As a scoping review, the search drew from three databases; this may have limited findings of studies. The review also focused on interventions designed or delivered by occupational therapists and missed the wider role of discharge planning, assessments and multidisciplinary intervention in recovery. It is difficult to separate the benefit occupational therapy from multidisciplinary interventions, given team working in acute mental health inpatient services.

Furthermore, despite the values of choice and least restrictive practice in occupational therapy, inpatient mental health settings can be restrictive and may offer limited choice and meaningful occupation.

-Host's rationale for article selection-

I work in an inpatient acute mental health setting, supporting people with rehabilitation. I found the scoping review was useful to understand multiple interventions through one piece of research. I was interested in reviewing evidence and interventions used by other occupational therapists - and felt reassured by the summary of findings.

In recent times, I have felt more confident to challenge restrictive practices, in order to support patients' independence and choices. I resonate with the focus in the article - on meaningful occupation - not just activity, which my colleagues assume is the same.

I was reminded of the importance of sensory strategies and how they can support individuals who often present with complex emotional and neurodiverse needs in acute inpatient settings.

It reaffirmed my role as an Occupational Therapist, in offering sensory assessment to support with stress management, despite the additional time it takes to complete. This can promote independence and help patients reduce distress in restrictive and sensory-overwhelming inpatient environments.

-Original journal article-

-TO FELLOW JC MEMBERS-  What are your thoughts on this article and/or the views shared by host Abigail?