Mental Health, Occupational Therapy, and How The Two Relate

The motto of occupational therapy is “Living life to its fullest.” In order to help clients do that, occupational therapists (OTs) will want to understand mental health, occupational therapy, and how they’re related—in addition to prescribing physically assistive interventions. 

Mental health occupational therapy interventions aid holistic and client-centered care—helping clients participate in their daily lives across their entire lifespan. 

When the client is unable to participate in their favorite activities, whether due to a physical or mental illness, OTs use a holistic approach to adapt the environment or task to fit that person’s abilities. 

Cultivating a client-centered approach is an integral part of the occupational therapy process—and that often includes gaining insight into a client’s mental health. 

In this article, we’ll go over the courses and skills OTs need to practice a form of merged “mental health occupational therapy.” Additionally, we’ll share some mental health occupational therapy interventions OTs can use in their work. 

The role of an OT in mental health

Occupational therapists work with clients of all ages and walks of life. They also work in many different settings, depending on what individual clients and their families need. 

An OT may work with clients who have been admitted to the hospital for a brain injury to help address any subsequent cognitive defects. They also may work with clients in a community health center helping them manage conditions like bipolar disorder. 

In each of these situations above, an OT would work with the client to help them live independently or perform their daily tasks and activities. Often, OTs will also do an assessment of a client’s environment and make equipment recommendations to ensure safety and practicality. 

OTs also work to adapt clients’ work responsibilities to help accommodate changes in clients’ physical or mental abilities. 

When working with school-aged children, OTs may help them develop the skills they need to use in school, such as handwriting or managing their behaviors in the classroom.

Because occupational therapists take a holistic approach to client care, mental health occupational therapy is an area of focus that OTs use to inform their care. 

The history of mental health occupational therapy 

A full understanding of the role of occupational therapy in mental health would be incomplete without an acknowledging Eleanor Clarke Slagle’s contribution. 

Slagle was a social worker and early pioneer of using occupational therapy for mental illness, and is affectionately known in the field as the “mother of occupational therapy.” She trained students at the Hull House, and started a therapy program, arguably the first mental health occupational therapy program, for state mental institutions in Illinois in 1918. 

Her program’s success led Slagle to direct similar programs in mental hospitals in other states, and established that occupational therapy is inextricably linked to mental health.

The development of habit training

Slagle was interested in the Mental Health Hygiene Movement, which focused on the promotion of mental health and prevention of mental illness, rather than reactive treatment. 

With input from psychologist Adolf Meyer, one of the leaders of the movement in the US, Slagel was one of the first people to incorporate habit training into occupational therapy—one of the earliest mental health occupational therapy interventions. 

Habit training focuses on the balance of activities in work, rest, and play, to establish healthy habits and restore mental health. 

When used by OTs in treatment, habit training occupational therapy interventions can help individuals manage and maintain their personal hygiene, take public transportation to work or school, and learn coping skills for certain mental health concerns. 

The Deinstitutionalization Movement

In the 1960s, the Deinstitutionalization Movement pushed for mental health facilities to close, so that people with mental illness would instead be treated in community settings. Rather than living in institutions, those with mental illness were encouraged to live in and get support from places like groups homes. 

As part of that shift, the service delivery method also moved away from the medical model, which focuses on physiological causes and medication management as primary treatment. Instead, practitioners embraced a recovery model, which empowers the patient to take control of their lives and build resilience. 

With health care moving toward a client-centered approach, clinicians focused on coping skills and practical adaptations to promote sustainable mental and physical health—aka mental health occupational therapy interventions. 

Eventually, the practice of mental health occupational therapy became an essential part of holistic community care.

Occupational therapy in mental health

The most common issue in  occupational therapists’ mental health work is occupational deprivation. 

Occupational deprivation occurs when a client experiences prolonged inability to participate in necessary and meaningful activities—for reasons outside of their control. It can lead to clients feeling social isolation and generally hopeless if left unresolved, which can compound existing mental health issues or even introduce new ones.

This is why it is crucial for occupational therapists to take a holistic approach to treatment. OTs need to consider not only the physical factors of illness or injury, but also the psychosocial and emotional needs of our clients.

Mental health professionals are well-versed in the mental and emotional impact of injuries, disabilities, or disease. Traumatic or chronic pain, the loss of a role, or general intense feelings of hopelessness can lead to depression, anxiety, and post-traumatic stress disorder (PTSD). 

Clients with these disorders may already be seeking psychological or psychiatric treatment. However, they could still benefit from mental health occupational therapy. 

OTs working in these settings can offer clients mental health occupational therapy interventions as a supplemental treatment approach. 

For clients who don’t want or don’t need to to take medication, OTs can work with them to encourage meaningful, routine self-care practices. Things like using essential oils, journaling, or practice meditation can often help manage some of the effects of mental health disorders.

To learn more about mental health occupational therapy, OTs can take continuing education (CE) courses. Mental health occupational therapy courses can be found on state board websites, AOTA, or NBCOT. 

Collaborative care for mental health occupational therapy

Interprofessional collaborative practice (ICP) occurs when multiple health workers from various professional backgrounds work together with patients and their families to deliver high quality, comprehensive care. 

The benefits of ICP include improved access to healthcare interventions, increased coordination of care between patients and their family, increased safety in healthcare, efficient use of resources, increased employee satisfaction with reduced stress and burnout in the profession, and much more.

Occupational therapists and other mental health professionals are perfectly suited for the execution of ICP. Both fields value a client-centered approach to care, which integrates the client’s input and their comfort level in their care. 

Although practicing mental health occupational therapy is a very useful skill for OTs, it’s best utilized when in partnership with a mental health professional. 

In collaboration with one another, the mental health clinician and the OT can apply mental health occupational therapy interventions that are client-centered and ensure the best, most comprehensive care possible.  

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