Advancing Occupational Therapy in Mental Health Practice looks at the contribution that occupational therapists make to the lives of clients living with mental illness. It examines current practice developments and the innovative research that is shaping occupational therapy within the mental health arena, nationally and internationally.

The book employs a distinctive and engaging narrative approach, bringing to life key issues in practice and research. It introduces the reader to the mental health context, opening with a historical overview and then exploration of the current developments in occupational therapy before moving on to discuss the cultural context and the need for cultural sensitivity in practice. Service users and expert clinicians offer their narratives, through which the clinical utility and cultural appropriateness of existing occupational therapy concepts, assessments and outcome measures are discussed and the associated implications for practice highlighted.

Advancing Occupational Therapy in Mental Health Practice introduces and explores a variety of specialised work contexts from practicing in acute inpatient settings to crisis intervention, home treatment, forensic mental health settings and the specialist role of occupational therapy in community mental health and social services. Chapters are enriched with case stories, personal narratives and guided reflection.

Dr Elizabeth McKay is Head of the Department of Occupational Therapy at the University of Limerick, Ireland. She has published previously on narratives and mental health practice.

Christine Craikis Director of Occupational Therapy at Brunel University, UK. She has contributed extensively to mental health policy and to the evidence base.

Kee Hean Lim is Lecturer in Occupational Therapy at Brunel University, UK, and Education Officer of the College of Occupational Therapists Specialist Section: Mental Health.

Gabrielle Richards is Professional Head of Occupational Therapy at the South London& Maudsley NHS Foundation Trust, UK, and past Chair of the College of Occupational Therapists Specialist Section: Mental Health.

Contributors vii

Preface ix

Part I: Introducing the Mental Health Context 1

1 What have we been doing?: A historical review of occupational therapy 3Elizabeth Anne McKay

2 The changing face of occupational therapy in mental health 17Gabrielle Richards

3 Cultural sensitivity in context 30Kee Hean Lim

Part II: Exploring Practice Contexts 49

4 Engaging the disengaged: Practising in acute in-patient settings 51Samantha Dewis and Michelle Harrison

5 Broadening horizons: Beyond acute mental health 63Michelle Harrison and Samantha Dewis

6 Doing in secure settings 76Elaine Hunter and Elizabeth Anne McKay

7 Occupational, social and intrapersonal alienation explored in the community 89Wendy Bryant

8 Strengths and challenges to practice: Reconciling occupational justice issues as a prerequisite to mental health recovery 103Karen L. Rebeiro Gruhl

9 The art of occupation 118Jacqueline Ede

10 Vocational rehabilitation in the UK: How occupational therapy can contribute 132Carla van Heerden

11 Powerful stories and challenging messages 147Graeme Smith

Part III: Research and Future Directions 159

12 Reviewing consumer-run mental health services 161Samson Tse and Carolyn Doughty

13 Twists and turns: The development of a clinicalacademic career pathway 189Edward A. S. Duncan

14 Researching within mental health: Slow and steady a Canadian tour 204Thelma Sumsion

15 Future prospects for occupational therapy in mental health 215Christine Craik

Index 227