Breaking the Cycle: Occupational Therapy’s Inclusion in SAMHSA Mental Health Legislation

Back in November, I wrote about occupational therapy’s role in mental health, specifically the profession’s advocacy for occupational therapy’s inclusion in the Substance Abuse and Mental Health Services Administration (SAMHSA) legislation that will create Certified Community Behavioral Health Clinics (CCBHC).

On February 2nd, SAMHSA released their draft criteria (which you can read here) and occupational therapy is one of the professions that have been identified as potential CBHC providers! Although the document is just a draft, which means that we aren’t officially in the door, it’s still an important stride being made for the profession and for the clients who OTs have the potential to help in the future.

Occupational therapy actually has its origins in mental health, beginning with the moral treatment movement in the early 1800s and continuing throughout World War I, when “reconstruction aides” used crafts, functional activities, and their understanding of the human desire to live a productive, meaningful life to help returning soldiers cope with their physical and psychological injuries (AJOT, 2011). Unfortunately, in recent years occupational therapy has lost its footing in the realm of mental health due to political and legislative actions, professional identity shifts, poor professional advocacy, and other factors. This has led to a sort of vicious cycle of OT’s exclusion from the arena of mental health, which I’ve illustrated in the graphic below:

OT in Mental Health Cycle Graphic

Negative outcomes of this cycle include:

  • Decreased access to qualified mental health service providers by those who need services
  • Healthcare teams that are missing a valuable occupational therapist perspective on client treatment and recovery
  • Fewer opportunities for assessing or developing intervention and treatment methods that may be effective with clients with mental health concerns

However, with occupational therapy’s inclusion in SAMHSA’s CBHC draft comes a chance to break the cycle and make it known that occupational therapists bring valuable tools, insight, and clinical expertise to the field of mental health. In the same article I cited previously (available in full to AOTA members), the author offers several practical solutions to help remedy the current shortage of occupational therapists practicing in mental health, including increased professional advocacy at the state and local levels for the effectiveness of OT in mental health and high-quality research to support this conclusion.

I think that occupational therapy has a bright future in mental health, and I am hopeful that the next generation of therapists will be better-prepared, more confident, and capable of taking on the many challenges presented by working with people living with mental health concerns. We’re now one step closer to breaking the cycle, and I’m excited to see what happens when we reestablish our role as qualified mental health professionals!


Links

If you’re interested in learning more about occupational therapy’s role in mental health, check out these articles describing how the unique skills of OTs have made a difference in the lives of people with mental health concerns, including children, veterans, and families.

Military Service Members and Veterans: Occupational therapy interventions help veterans living with PTSD re-establish routines, learn how to cope with their symptoms, and successfully rejoin their communities.

Children & Adolescents: The community-based OT that the high school student in this article is seeing is helping him learn independent living skills that will help him become less dependent on his family members and likely ease the caregiver burden his mom reports experiencing.

Professional Opportunities for OT in Mental Health: AOTA President Ginny Stoffel authored a useful article that reviews the multiple opportunities for occupational therapy in mental health, including having OTs be members of primary care and “integrated treatment” teams and the important role OTs can play in the recovery of clients with mental health concerns.

References:
Special Issue: Effectiveness of Occupational Therapy Services in Mental Health Practice. Am J Occup Ther 2011;65(3):235-237. doi: 10.5014/ajot.2011.001339.

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