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Occupational Therapy in Mental Health

The past outbreak of the COVID-19 pandemic unveiled an undeniable global reality concerning the mental health of different people, at many levels, as a result of imposed change in routine and disruption of normal life. These have further intensified and amplified the pre-existing mental health challenges in different countries. South Africa is one of these counties where the mental health challenges have become prominent, obtaining the lowest score when comparing mental wellbeing in different countries [1]. Furthermore, it is projected that there will be a concerning long-term impact, with mental health challenges significantly on the rise.

Among many mental health challenges, depression has been recently identified as the leading cause of disability worldwide [2]. The South African Depression and Anxiety Group’s statistics for 2021 further emphasises the deteriorating mental health of South Africans by indicating having received 85 516 Suicide helpline calls between January to September 2021 – an estimate of around 2 200 calls per day [3]. The COVID-19 pandemic led to significant changes in occupational performance, roles and daily habits [4]. These changes, in turn, sparked substantial fear, anxiety and stress. These stressors have necessitated and increased the need for Occupational Therapy intervention, as part of the multidisciplinary team who assess, treat and support clients with mental health challenges.

In light of the COVID-19 pandemic, the role of Occupational Therapy has become a cornerstone in maintaining an optimal level of function through addressing the client’s immediate needs. Priority focus areas includes the construction and maintenance of a balanced daily routine, the planning and implementation of self-care tasks during isolation, the facilitation of healthy social interaction and communication of needs, emotional regulation and expression, sensory self-regulation, future goal-setting, addressing the self-subsystem, and the reintegration into the physical work/ school environment.

Further emphasis has been placed on the acquisition of life skills, such as healthy stress management and coping skills during an ever-changing period of time, the development of healthier habits and the implementation of conflict management within strenuous home environments among others.

With an increased number of mental health challenges experienced due to the COVID-19 pandemic, occupational group therapy has effectively been used as mode of treatment, to support larger amounts of people in need, while ultimately preserving time and human resources. This has been recognised as a well-established and highly effective treatment option within mental health settings in South Africa. As part of the effects of COVID-19, imposed ‘work from home’ conditions as well as prolonged periods of quarantine have led to concerning self-isolation, occupational performance dysfunction and overall social deprivation. When addressing the specific impacts of COVID-19, group therapy has been used successfully to address social interaction (the fear of interacting with others again, communicating in person, social anxiety, etc.) through interpersonal learning, by modelling and facilitating healthier social engagement within the group setting [8].

Therefore, a therapeutic environment based on a client-centered approach, conducive to the development of healthy interpersonal skills, as well as where it would be safe for group members to take risks, experiment with new behaviors and provide feedback to one another, provided a safe space for healing [6]. It is through different therapeutic factors, such as installation of hope, universality, interpersonal learning, cohesion, catharsis and existential factors that change is guaranteed [7].

According to literature, occupational therapy also plays a key role in trauma recovery. The occupational therapy treatment approach is able to unearth uncomfortable traumatic experiences and facilitate a process of healing and closure, through the use of various therapeutic activities and movement-based groups (such as psychodrama, projective techniques and guided imagery).  Furthermore, it has been found that Broca’s area (the area involved in expressive speech) of the brain tends to shut down during traumatic events, leading to suppression of the trauma due to an inability to articulate experiences. This further prevents the client from successfully processing and achieving closure. Occupational therapy effectively assists in the integration of the left and right hemisphere, facilitating the effective identification and processing of trauma, amongst other things [9].

Article by: Esté Roberts, B.OccTher (UP), Laura Pakendorf, B.OccTher (SU), July Masango, BSc(OT) (WITS); PGD voc rehab (UP); Cert Practical Labour Law (UCT); MOccTher (UP); Candidate PhD, (WITS)

Reference list:

  1. “SA is struggling, new mental health study finds,” Times Live, 16 March 2021. [Online]. Available: https://www.timeslive.co.za/news/south-africa/2021-03-16-sa-is-struggling-new-mental-health-study-finds/. [Accessed 22 August 2021].
  2. Pols T. Mental Health South Africa Statistics and Information | SAME Foundation [Internet]. SAME Foundation | Free to live. Free to learn. 2019 [cited 13 February 2022]. Available from: https://www.samefoundation.org.za/mental-health-a-growing-condition-in-healthcare-for-south-africa/
  3. Heywood M. Maverick Citizen: Tuesday Editorial: South Africa’s mental health epidemic: Love Don’t Live here Anymore [Internet]. Daily Maverick. 2021 [cited 13 February 2022]. Available from: https://www.dailymaverick.co.za/article/2021-10-12-south-africas-mental-health-epidemic-love-dont-live-here-anymore/
  4. Lannigan E, Tyminski Q. Occupational Therapy’s Role in Addressing the Psychological and Social Impact of COVID-19 [Internet]. Pubmed. 2020 [cited 13 February 2022]. Available from: https://pubmed.ncbi.nlm.nih.gov/34405802/
  5. “National Mental Health Policy Framework and Strategic Plan,” Department of Health, Republic of South Africa , 2013.
  6. Fouché, “History of the Interactive Occupational Therapy Group Model of Voster & de Beer,” in OT Grow Experiential Workshop , Pretoria , 2019.
  7. Group Therapy – The Bergand Group [Internet]. The Bergand Group. [cited 13 February 2022]. Available from: https://bergandgroup.com/group-therapy/
  8. Fouché, “Psychosocial: Interactive approach introduction,” in OT Grow Notes , Pretoria, 2019.
  9. Crouch, R. and Alers, V., 2014. Occupational Therapy in Psychiatry and Mental Health. 5th ed. John Wiley & Sons, Ltd, pp.339-340.

 

Last Updated on 26 October 2023 by HPCSA Corporate Affairs