An exploration of occupational balance in community-dwelling service users attending a mental health rehabilitation day centre

Abstract

People struggling with mental illness often experience multiple functional limitations that hinder participation in occupations. Additionally, they experience segregation, resulting in decreased opportunities for a wider range of occupations, leading to an imbalance in occupation. This research study aimed to explore occupational balance among service users attending Occupational Therapy community rehabilitation day centres. The study also sought to shed light on Occupational Therapists (OTs) perspectives on occupational balance and their role in supporting service users to maintain balance. The study used both quantitative and qualitative data collection tools and consisted of two phases of data collection. All participants were recruited through an intermediary using purposive sampling. The first part was more quantitative in nature. The first set of participants’ were service users who resided in the community and were independent or required moderate assistance in activities of daily living. Short questions were used along with an activity configuration chart to explore service users’ routines and occupations. The second phase of the study consisted of a focus group with OTs who worked in community rehabilitation centres and had at least six months of experience within a mental health setting. The service users' response were discussed with the therapists during this phase. Qualitative analysis was used to understand the OTs perceptions of occupational balance in-depth through a focus group. Results showed that mental illness can affect occupational balance differently according to the service user since it depends on life stage, demands and ability to adapt. It is also dependent on the impact of symptoms and financial situation due to reduced opportunity for employment, secondary to stigma and occupational injustice. Thus, occupational balance is subjective and depends on personal aspects of an individual. Although occupational engagement was affected, service users still felt satisfied with their routines. A greater understanding of occupational balance could improve OTs ability to support service users to integrate and engage in a wider range of occupations, so that they do not feel they are not good enough. Occupational balance could be an area where OTs can demonstrate and communicate their unique approach to therapy.