Community-based occupational therapists’ experiences working with clients with chronic and complex conditions: a qualitative analysis

Dr Olivia King1,2,3, Ms Kate Ingwersen1,4, Ms  Brooke Bufton1,4, Dr Danielle  Hitch4,5, Ms Brodie Dupre6, Ms  Melita  Harding6, Ms Catherine Mayhew7, Ms  Sarah van de Ven1,4

1Barwon Health, Geelong, Australia, 2South West Healthcare, Warrnambool, Australia, 3Monash Centre for Scholarship in Health Education, Clayton, Australia, 4Deakin University , Geelong, Australia, 5Western Health, Sunshine, Australia, 6IPC Health, Melbourne, Australia, 7Gateway Health, Wangarratta, Australia

Community-based occupational therapists (CBOTs) work with clients with chronic and complex conditions, who may also be experiencing high prevalence mental illnesses: anxiety, depression, and distress. Little is known about CBOTs’ experiences engaging with clients with mental illness, and their strategies to assess and support these clients.

Our qualitative research addresses two questions. What are CBOTs’: 1) experiences working with clients with high prevalence mental illnesses? 2) strategies or tools to support their assessment and management of clients’ mental health?

Six group interviews were undertaken with CBOTs from three health services in rural, regional, and metropolitan areas. Participants were asked to describe an experience working with a client with mental illness and to identify strategies or tools drawn on to guide mental health assessment and support. Data were analysed using a team-based framework approach.

Common themes identified in the 22 experiences described were: a perceived tension between meeting clients’ mental and physical health needs; time taken to support and manage mental illness, and the impacts of managing clients’ mental health on CBOTs. Participants identified various strategies used to assess, support and manage clients with mental illness: making referrals as appropriate, flexibility in their approach, basic OT and general counselling skills. Despite their availability, participants reported not routinely utilising mental health screening tools.

CBOTs frequently work with clients with mental illness which impacts their engagement, management plan and CBOTs themselves in multiple ways. Our study highlights opportunities to integrate routine mental health screening into standard CBOT practice, to support comprehensive client-centred care.


Biography:

Olivia King is an Allied Health Research and Translation Co-Lead at Barwon Health and South West Healthcare (with Dr Rosalie Boyce). She also holds an Adjunct Research Associate position with the Monash Centre for Scholarship in Health Education (MCSHE). She is a qualified podiatrist and credentialled diabetes educator. She completed her PhD in 2018, which explored the role boundaries and scopes of practice in diabetes education, a postprofessional area of clinical practice. She is passionate about developing research capacity in the health sector. She has primarily undertaken qualitative research and her research interests include, interprofessional role boundaries, sociology of the professions and health professions education.

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