In 2022, more than five million people in Canada met the diagnostic criteria for a mood, anxiety, or substance-use disorder, which amounts to about 13% of the population. For many, poor mental health is a barrier to living a full and productive life. Occupational therapy is a mental health treatment that can help them learn to adapt and participate more fully in the activities that give their lives stability, purpose, and joy.
Repairing connections to daily life
Mental illness impacts every aspect of a person’s life, including their ability to participate fully in social, recreational, and employment activities. People who face mental health challenges can find themselves unable to work, attend school, or even enjoy activities such as hobbies or sports. As a result, their world becomes smaller and they become more isolated as their connections with the outside world are broken.
Among employed Canadians, 7.5% said they had taken time off from their job or business because of stress or for mental health reasons in the 12 months before April 2023. Every week, about 500,000 Canadians are unable to work due to poor mental health, resulting in 16% of working hours being lost to absences and presenteeism due to mental health issues.
Being unable to work has consequences that go beyond financial uncertainty. Work is a fundamental aspect of our identity and role within society. It gives structure to our lives, provides us with a sense of purpose and belonging, and brings us the respect of our peers.
The same is true of school, and similarly, the ability to attend school regularly is often interrupted by mental illness. A 2017 Ipsos survey of Ontario youth found that 46% of students surveyed reported missing school because of anxiety. And when they do attend, they don’t see as much benefit from the experience: children with poor mental health are 3.5 times likelier to have average grades of C or lower, and 25 times likelier to experience difficulty making friends.
Occupational therapy and mental health
Occupational therapy is used in many contexts, and occupational therapists can be found in a variety of settings. In a school, you may find them helping children develop skills and behaviours that will help them thrive in an academic setting. In a hospital, they can be found helping people with cognitive or physical limitations re-learn specific tasks or find new ways of doing things so that they can regain independence. In a mental health and addiction treatment centre, occupational therapists help people with depression, anxiety, post-traumatic stress disorder (PTSD), addiction, and co-occurring disorders to manage their conditions and regain their ability to take part in the everyday activities that make up daily life.
While physicians and psychiatrists make diagnoses, prescribe medication, and create individual treatment programs, occupational therapists help people with mental health conditions learn new ways of participating in work, school, and leisure activities by regaining or acquiring new skills, and adapting their environment (or their response to it) in ways that make it easier for them to participate in various activities.
Part of an integrated mental health treatment
Mental health treatment requires a holistic approach that supports the whole person, including physical, mental, emotional, social, cultural, and spiritual components. Occupational therapists work closely with other practitioners and specialists to form a collaborative team that delivers holistic care.
This team can include physicians, psychiatrists, physiotherapists, prime therapists, nursing staff, addiction specialists, registered dieticians, recreational therapists, music therapists, art therapists, and horticultural therapists.
The role of the occupational therapist is unique in that it overlaps with and complements many other disciplines. In the context of mental health treatment, occupational therapy focuses on how the patient’s mental state—their thoughts and emotions as well as the symptoms of mental illness, such as fatigue, loss of motivation and meaning, fearfulness and hypervigilance—are preventing them from participating fully in every aspect of a balanced life.
How occupational therapy aids in mental health treatment
At Ravensview, a private mental health and addiction treatment centre on Vancouver Island, British Columbia, the occupational therapist uses a range of evidence-based approaches to support their patients in returning confidently to day-to-day life. These approaches can include:
Cognitive restructuring techniques: These therapeutic techniques help people recognize, challenge, and change negative thinking patterns that can become limiting and self-defeating.
Problem-solving skills training: This intervention gives patients the tools they need to identify problems and find ways to solve or adapt to them.
Activity exposure: Within an inpatient setting, occupational therapists help the patient build confidence by giving them a safe, controlled way to acclimatize to the environment and activity that they need or want to return to.
Supportive structure: Occupational therapists often help patients to create daily routines and set specific goals that help them progress along a path toward the desired lifestyle.
Motivational interviewing: Through empathetic, person-centred counselling, occupational therapists explore and resolve ambivalence, build personal motivation, and develop a plan for behavioural change.
During the treatment, the occupational therapist identifies medical and non-medical issues that are impacting the patient’s capacity, helps the patient improve their ability to identify and manage those issues, and supports the patient in strengthening their motivation for returning to work, school, or social and leisure activities.
The impact of occupational therapy
Effective mental health treatment takes a multidimensional view of a person’s life, including work, school, recreation, hobbies, and human interaction. By helping patients reconnect with these dimensions, occupational therapy can play a significant role in a patient’s recovery.
Including occupational therapy in a patient’s treatment journey can help to break a vicious cycle, where a person with mental illness withdraws from work, school, exercise, leisure, and social activities, which in turn puts them at greater risk of poor mental health. In fact, this type of therapy can help to accelerate recovery by creating a “flywheel” effect, where the return to fulfilling activities helps to accelerate the patient’s return to health through participation in meaningful and beneficial activities.
Occupational therapy helps people with mental health issues achieve a number of crucial recovery milestones:
Increase physical movement. The link between exercise and mental health has been extensively researched and confirmed. Evidence from a meta-analysis of 49 studies spanning 260,000 participants shows that people with higher physical activity levels are less likely to develop depression, which is why recreational therapy also plays an integral role in mental health treatment.
Get back to work. The inability to perform work has financial and psychological consequences, resulting in a loss of self-esteem, work relationships, structure, and purpose. A meta-analysis found that 14 of 16 longitudinal studies on the impact of unemployment and mental health showed a significant, negative association. By helping people return to gainful, meaningful employment, occupational therapy improves their mental health.
Create social connections. Depression, anxiety and cognitive decline (in older people) are all associated with social isolation and having fewer social ties. Research from Statistics Canada showed that 62% of socially connected people with mental health-related disabilities rated their mental health positively compared to only 49% of those who were not socially connected.
Enjoy hobbies. Research shows that having a hobby is linked to lower levels of depression – and may even prevent depression for some people—even those who have clinical depression. Spending time outside in nature has also been shown to have a protective effect on mental health, as do creative pastimes such as music and art.
We are what we do
For most of us, what we do on a daily basis defines us and gives us our sense of identity and self-worth, whether it’s the contribution we make to the world through our work or the things we do in our down-time that bring us joy. When we experience a mental illness, we often lose those essential parts of ourselves. Occupational therapists help patients find ways of regaining them so that they can participate in and benefit from a return to normal, daily life.