Occupational Therapy in Community Mental Health: Paper versus Practice

Abstract

Community mental health teams (CMHTs) commonly include workers with different educational backgrounds in dual roles including generalist (e.g., case manager) and specialist duties (e.g., occupational therapist) (Culverhouse & Bibby, 2008; Parker, 2001). Little has been done to examine how occupational therapists (OTs) working on CMHTs understand their professional roles in relation to existing governing documents. Methods included a document review and content analysis identifying the role on paper, compared and contrasted against individual interviews highlighting OTs roles in practice. The study finds direction lacking from governing texts related to occupational therapy on CMHTs. OT practices are informed largely by previous student and work experiences, client needs, individual therapist skills, and team makeup. OTs find themselves experiencing seemingly opposing views (e.g., wide scope of practice vs. narrow scope; all alone in a crowd; ‘I do it all’ vs. ‘its all teamwork’). The lens through which one chooses to view one’s practice influences one’s perception of how much work is designated as occupational therapy-specific. Priority areas for improvement: 1) successfully navigating the dual role, 2) enabling more evidence-informed practice, 3) addressing role clarity, and 4) supporting clinical student placements on CMHTs.