Occupational participation and mental health: the path to overall well-being, a publication by Novasalud, holistic centre for addiction and mental health (Chile)
By Leonardo Estrada, Occupational Therapist, Staff Member at Novasalud – The current trends in approaching addiction and mental health problems have incorporated more areas of human development. We have evolved from reductionist health models, to holistic ones that view human beings as the interaction of many aspects which cannot be ignored. Thus, to the well-known biological, psychological and social aspects that are already taken into account in understanding mental health problems, occupational aspects are being added to provide an approach more in line with current models, recognising that participation in our society through roles is an expression of health.
Person-Centred Care Models prove to be the most suitable to accommodate therapy input within the framework that current models require. In this way, therapists can focus the objectives and strategies of an intervention on the particular feelings, thoughts and actions of the individual experiencing addiction (or any mental health diagnosis). This could result in therapeutic processes and personal development with a more practical, personal and meaningful sense, since what we work on with them would be directly related to what people experience.
In this sense, biomedical, psychological and social approaches are very important, yet incomplete; the rediscovery of the Occupational Therapist as the professional who encourages ‘Occupational Participation’ and, through it, social integration and inclusion, turns out to be the answer to the questions that the emerging models themselves ask us: how do we promote the overall well-being of people with mental health diagnoses?
How do we respond to the individual demands of people, who ask to be more active and involved in the processes, to make decisions, to respond to their particular needs…? In other words, they seek to be part of, and to participate, not only in the therapy process, but also in life itself, the same life from which they were somehow isolated as a result of clinical and cultural approaches.
This last point is fundamental. Every mental health diagnosis (or crisis of the same nature) is experienced as a break in the individual’s life, in which their life plan is interrupted, and the individual loses the capacity to choose and move forward in their goals. Although this dynamic can be understood by a Psychiatrist or explained by a Psychologist, it is the Occupational Therapist who can assess and intervene, since this is the person who supports ‘Occupational Participation’, which could be defined as the combination of activities and pursuits which promote well-being through integration by doing. Explaining the dynamics of ‘Occupational Participation’ from the perspective of the individual permits them to put into place the appropriate and necessary support to give stability to the person’s experience, to include them in its creation and to visualise positive and practical changes in the therapy process. Therefore, the importance of ‘Occupational Participation’ in well-being is fundamental, since it is through this that the individual manages to integrate themself into the dynamics of society, achieving what they want from themself in accordance with what society might expect from them.
In this respect, the figure of the occupational therapist in the approach to addiction is not fully explored, or made the most of. In our country, and due to the lack of information, Occupational Therapy has been principally related to socio-professional reintegration and the prevention of relapse through intervention in people’s daily routines, especially their free time. However, a more comprehensive review of the Conceptual Models of Occupational Therapy Practice accounts for greater depth in understanding the ‘Occupational Participation’ of the individual, the relationship between what motivates them to do activities, their skills, the type of tasks, environmental factors etc. This would allow an in-depth understanding of how people with addictions see the impact on the development of personal aspects, that go beyond work, such as carrying out parental, familial or friendship roles, the way they organise their day-to-day life, or how neurological changes in the reward circuit could alter the achievement of life goals in the medium to long term. In other words, understanding the real significance of person-centred Occupational Therapy and the experience of their daily life, allows them to direct the efforts of the therapy process towards overall well-being.