The Totality of Mental Health Practice

In this article, I intend to explore my premise of influence on defining mental health. The argument I make regarding mental health practice is fundamentally related to health as its defined extensively in my previous article: Defining health, purpose, and the meaning of life.  

These articles are long, due to the process of identifying and addressing the role of philosophy and underlying assumptions throughout; which is unavoidable without giving vague, broad, meaningless, definitions. Vague definitions can be easily be found elsewhere, such as “to help you achieve your full potential.” The definition I argue is: 

The totality of mental health practice is adjusting what has our focus.

This article will address what value there is in trying to attempt a definition at all, as well as what underlying assumptions must be addressed to make any concrete definition of mental health. 

Why I Write 

These articles are not a short and easy read meant for receiving high views. I do not believe my writing of these articles shall fix cultures problems, for I have come to believe through extensive reading, that most, if not all of healthcare’s answers and solutions are right outside the front door, lining the shelves of libraries, and waiting for the Grandchildren to visit.  

To address this topic, I will attempt to be grounded in evidence; which is to use a heuristic approach throughout these articles. The idea is, rather than holing myself up and writing a book, that at best would only be read by America’s already literate elite, I will write here, and take action now. 

As for my motive, I am writing several in-depth articles for these reasons: 

  • To motivate myself to learn, and then reflect on the progress 
  • To organize what I learn coherently for family and friends 
  • To facilitate discussion among peers in order to weigh and evaluate the evidence 
  • To refine my understanding as I try to make positive health behavior appealing to others 

This article is influenced by the current state of America, though attempting to use universal concepts.  It should be noted however, that comparing healthcare problems internationally, is really in colloquial terms “comparing apples to oranges.” There are countries in great poverty with poor mental health nationally. There are also countries in poverty, by industrialized standards, with much greater reports of happiness and life satisfaction. There are countries with high average and overall socioeconomic status, with poor mental health, and also the opposite (Buettner, 2017; Helliwell et al., 2017). Some argue, such as Dr. Stephen Ilardi (TEDxEmory, 2013) that depression is a “disease of civilization”, similar to diabetes. While divisive, Ilardi takes strong to the nurture end of the nature vs. nurture debate calling depression a “disease of lifestyle.” However, this cannot necessarily be generalized to all mental health disorders. Though I think there may be some truth to this, I argue that the correlation is not the whole of the causation. As Wiking argues in his book Lykke (2017), “health and well-being should be separated.”

The challenge I see is this; there is “all talk and not enough action regarding health, particularly in America. I do not necessarily mean that metaphorically. Quite literally, depression and sedentary activity are on such a rise, that a literal lack of action is a good part of the problem. I don’t say this to condemn people, but to recognize this; bills need to be paid, kids fed, houses cleaned, groceries to be picked up, jobs to be attended, and relationships to be fulfilled.  

Introduction 

It seems that mental health is related to life as we experience it; which is quite subjective. Reasonably so, since the inception of psychology as a science, there is no shortage of perspectives of what we must do to achieve or maintain mental health. It is difficult then, to make any suggestion of what mental health practice is, without being incredibly vague. Presumably, in a vague way, therapy is to “help us reach our full potential” or “make us better” or “healthier” or “happier.” Truly, any attempt to narrow down or describe mental health and the practice of it, in anyway, is to come into disagreement with some theory, philosophy, psychologist, or field of thought, eventually.  

Freud argued that we had a will to pleasure. The philosopher Nietzsche, argued that humans had the will to power, which influenced Alfred Adler’s break in direction from Freud. Frankl Argued we had a will to meaning. I would argue, that Maslow’s Hierarchy of Needs could be described as a will towards self-actualization. Yet at the basic level, they each are influenced by an underlying assumption; that humans have a will at all. Somewhere, there is someone who would argue there is no will, such as the extreme behaviorist.

Then I might say, there is no doubt, at least the perceived experience of will. If not for you, than I speak for myself in truth. Yet in regards to the other will to [fill in the blank]; each of those concepts involve a will to change. From a pragmatic perspective, there is something fundamental in the human; that a percieved will exists. This may best be captured by Williams James’ 1892 written explanation: 

“The fundamental Fact. – the first and foremost concrete fact which everyone will affirm to belong to his inner experience is the fact that consciousness of some sort goes on. ‘States of mind’ succeed each other in him.” (James, 1984). 

Returning to a pragmatically influenced approach, and with the understanding of what positive mental health should be, as I have previously argued, I shall resume from that standpoint, what positive mental health practice is.  Which as I stated at the beginning of this article:

The totality of mental health practice is adjusting what has our focus.

I may be wrong, I accept that.  

But, if a truth exists at all in my statement, I can only benefit from being wrong in order to learn what is right.

Where I stand is, that there must be some objective truth out there. There must be some objective truth, as to what is “best” for us as a collective and/or for us as individuals. I believe that any psychology or mental health theory, is merely an attempt at discerning that truth, but that truth remains regardless. I am more interested in describing the theme I find most pertinent to share, that I argue, all mental health practices attempt to accomplish whether they agree or not. 

To make one final point clear, I do not believe I truly argue for a new definition of health, but rather, for using modern language to better define that truth which has always existed. Certainly, there has been examples of wide-spread health as well as understandings of health, centuries before our time. Even in many places today, as the National Geographic Fellow Dan Buettner (2017) has described in his book Thrive, great health often exists with traditional understandings.  

I would argue there to be an objective truth underlying what health is, in relation to the human condition, that has always remained the same. If I use any words, it’s only in an effort to translate, using modern day language, a reality that existed before my time.  

The 3-point thesis statement defining health that I argued in my last article, is listed below: 

  1. The meaning of life may be unique for everyone, but finding it is the same.
  2. Meaning in life is found through purpose, which is defined by the act of a person to focus on priority.  
  3. The practice of focusing on priority, also defines purpose, which is where we will find our meaning. 

To review a few key points from my previous article: 

  • I also believe, mental health is directly and fully related to purpose. Positive mental health is the ability to pursue purpose. Negative mental health, is any barrier that prevents that pursuit; and that pursuit being comprised of the ability to focus on one’s priorities. 
  • Rather, mental health is the ability to focus on priority, which is in many other terms, to “live and pursue”, “goal-oriented”, “self-directed”, “purpose-driven”, “meaningful lives.” Mental health, is to know purpose, not happiness.
  • I shall argue, our mental health is mutually related to life as we experience it, and is determined by where our focus is placed. Changing where our focus is directed, is the act of prioritization. Therefore, positive mental health behavior, is taking any action to focus on positive priorities.

Existentialism: Hasn’t This Already Been Done? 

One could argue, my statements reflect a therapeutic approach similar to Existentialism. I did make several references to Viktor Frankl and his form of existential therapy known as Logotherapy. Another modern-day derivative is Meaning Therapy; which emphasizes meaning in well-being while including many contemporary mental health practices such as positive psychology and cognitive-behavioral therapy (Wong, 2014). I have disagreements with keystone existential philosophers, though my disagreements divulge into opinion more than worth noting here. The primary issue remains, that much to be debated is “all talk and not enough action”; as for the validity of there being a problem at all, I will later address that in this article. 

While what I argue may be related to forms of Existentialism in value of meaning and purpose; I would also argue, that while meaning and purpose may be the primary determinants of health, they are not necessarily the primary determinants of health-in-practice 

Put another way, Existentialism may be the ends, but is itself not enough of the means.  

Put yet another way, knowing meaning (existentialism) may help you find motivation to wash the dishes or pay the bills, but often these tasks need to take place before one could ever come to closure and fulfillment in discovering meaning in their life. 

That is what occupational therapy also contributes beautifully as a profession, to health-in-practice. I am biased to include my own profession. Occupational therapy recognizes, it is also through the engagement in everyday tasks that we will find our meaning, and not necessarily through guided talk therapy and activity alone (AOTA, 2014). While other forms of therapy may have their purpose in certain instances, I argue a two-fold truth exists. A top-down understanding and recognition of meaning and purpose motivates us to complete our every-day tasks; but also, a bottom-up engagement in every-day tasks, also helps us find meaning and purpose. 

A Purposeful Digression: What is The Problem? 

It could be said, that I ought to be careful in making any conclusions here. That to define health, purpose, the meaning of life, and therefore the role of any health practitioner, is too large a subject for a young novice like myself to address. That by publishing such descriptions and conjectures, I could mislead people, especially if I promote my material. 

My credentials are not the most extensive. However, I do have a high enough education (Masters of Occupational Therapy, Bachelors in General Studies, Minor in Psychology), to have an educated opinion from a scientific stand point that: A variety of influential experts disagree on key aspects of healthcare.  

To top that, prominent and primary resources such as certain government websites, list outright, wrong healthcare information as it is presented by primary works of scientific-evidence (which I would love to tell you about in person). I most certainly, am not the most qualified, and most certainly, have a great lot to learn. This is to say, you should not take my word as 100% accurate, as I do not either, nor anyone elses. What you should do, is question, as I have. It is no conspiracy that American “common sense” is not working. Why do I believe things are not working in America as is? 

  • Epidemically increasing rates of mental illness (SAMHSA, 2017) 
  • Epidemically increasing rates of chronic conditions (CDC, 2017) 
  • The world’s highest healthcare cost per person, and still increasing (Keehan, 2016) 
  • Current decreasing rates of life expectancy (Tinker, 2017) 
  • And decreasing rates of life satisfaction? (Helliwell, Layard, & Sachs, 2017) 

You may come to your own conclusions.  

I will not list directly, sources of wrong information; for that is one possible way to get sued (defamation). I will throughout the upcoming series of articles address topics with specifics. I will form my opinion, but will list sources, and direct information, to make easy, the follow-up of references to my sources.  

Why That Digression Was Needed 

I must first ask: 

  • What then is the purpose of writing and producing opinion?  
  • Is there not enough medical models and theories currently in existence?  
  • Is not, my argument for health being defined by purpose only simply “another way” to look at things? 

Simply; the answers to health are simple, and the ‘mainstream’ says it’s complicated. I must make my effort. 

When I first begin writing on this website, I wanted to systematically address mental health topics like mindfulness, coping skills, goal setting, and the like. In the process, I found myself questioning my own beliefs and returning to the literature and evidence. What I found, was continuously diverting opinions and arguments, though seemingly similar conclusions. I found it difficult to promote these practices without knowing how it fits in mental health as a whole. I then sought to address the fundamental paradigms (perspectives), guiding what health is. This led me to writing my previous article.  

In addition to my earlier stated thesis statement, there is an underlying philosophical belief guiding this writing. At some point, one has to ask themselves which they believe; Does an objective or relative truth exist? In fact, I’d argue, regardless of whether you think you know an answer, your actions are already influenced by your perspective of that question.  

This relates to mental health practice because as I will argue, mental health practices can only attempt to use fundamental truths of humans, to address their needs. Truths such as, the idea we are conscious beings. I will take a stance to stay, that psychology is the primary and most closely related practice, to addressing our mental health. Defining psychology is then worth-while, as well as its primary field of thought. Because ultimately, I’d argue that any mental health practice that works, fits into agreement with some type of universal truth. 

 

Psychology Defined 

Definition of Psychology: scientific discipline that studies mental states and processes and behaviour in humans and other animals. 

While there are most likely fans of some scientist, philosopher, or thinker, who might argue that undue credit is given to their name of choice, one of the most prominent names given to the “outset” of defining psychology as an independent and specific field of study in America, was William James. For William James, along with Wilhelm Wundt of England, are listed in the Britannica as being the primary influences. 

William James created a consolidated manual, a manifesto of sorts, that was pivotal in establishing the “what is psychology.” James’ book Psychology: a Briefer Course (1984) first published in 1892, remains an incredibly relevant book to read in modern times. While maybe certain topics, modern science has come to disagree with, more can be said about the fundamental accuracies in his book. These accuracies deserve an article of their own; such as his discussion of habit as it relates to willpower; which current leading opinions and scientific evidence, appears to be completing a 180-degree return back to James’ description, reflected in modern times by the works of those like Baumiester in his book Willpower (Baumeister & Tierney, 2011). However, I attempt to hold value in William James approach to writing known as Pragmatism. If I were to put pragmatism into my own words it would be: Some type of truth exists in the things that work 

In mental health, I would argue; some type of truth exists in the mental health practices that work. For example, most modern-day evidence as described by influential researchers, scientists, doctors, and journalists, agree that; Diets don’t work (Cambell & Jacobson, 2013; Mann, 2015, Pollan, 2008; Spector, 2015; Wansink, 2007).  I used dieting as an example due to the link (not causation necessarily) between nutrition and eating habits, with our mental health. 

However, many people do find that a diet did work for them. A pragmatic conclusion would be: “something worked, so some truth exists about what worked.” Maybe that truth is, for some people in some situations, they are motivated to change their habits because of attempting a diet. The point being, rather than focusing on dieting being wrong or right, a pragmatic approach is interested in what worked. 

The effectiveness of a mental health practice then, has more to do with its relation to “some type of truth” in the human condition, than to modern medicine and science. Modern medicine and science is for the purpose of discovering those truths for literature and practice, despite that those truths may have been practiced and known for centuries. William James would argue, psychology as a science was meant to find these truths. In his book, he defined psychology using another academics description stated below as: 

The definition of psychology may be best given in the words of Professor Ladd, as the description and explanation of states of consciousness as such. By states of consciousness are meant such things as sensations, desires, emotions, cognitions, reasonings, decisions, volitions, and the like (James, 1984). 

How this relates to pragmatism and defining mental health, is the attempt at objective pursuit of truth and understanding. It’s a style of writing that I will attempt to represent. This is why I take time to digress, as I did above. That in my search for truth, in my effort to share my believed understandings, I too, want you to both question for yourself and consider the fundamental truths that may exist.  

To return to what mental health practice is, I must make a few basic observations: 

  • Some mental health practices seem to work,  
  • some don’t,  
  • some, work better than others for different people. 
  • There is a wide variety of mental health practices. 
  • Still, there must be some universal truths regarding what will work better. 

Conclusion

It is here I return to my 3-point thesis statement regarding the meaning of life being related to health, which is defined by the ability to pursue purpose by focusing on priority. I do not argue this is a new way of looking at things, but the beginning attempts by a well-read novice (myself), to seek out the universal truths in mental health. That in relation to mental health practices, these truths converge on the human’s ability to focus.  Which is why I argue:

The totality of mental health practice adjusting what has our focus.

It is this focus, which I will address and explore in my next article, as well as provide specific examples. This focus I will argue, is fundamental to all mental health practices. 

References

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy. 68(Suppl. 1), S1-S48: http://dx.doi.org//10.5014/ajot2014.682006 

Baumeister, R. F., & Tierney, J. (2012). Willpower: Rediscovering the greatest human strength. Penguin. 

Buettner, D. (2010). Thrive: Finding happiness the blue zones way. National Geographic Books. 

Center for Disease Control and Prevention. (2017, 28 June). Chronic disease overview [webpage]. Retrieved from https://www.cdc.gov/chronicdisease/overview/index.htm  

Campbell, T. C., & Jacobson, H. (2013). Whole: rethinking the science of nutrition. BenBella Books. 

Helliwell, J., Layard, R., & Sachs, J. (2017.) World happiness report. Retrieved from http://worldhapiness.report/ed/2017/ 

James, W. (1984). Psychology, briefer course (Vol. 14). Harvard University Press. 

Keehan, S. P., Poisal, J. A., Cuckler, G. A., Sisko, A. M., Smith, S. D., Madison, A. J., … & Lizonitz, J. M. (2016). National health expenditure projections, 2015–25: economy, prices, and aging expected to shape spending and enrollment. Health Affairs, 35(8), 1522-1531. 

Mann, T. (2015). Secrets from the Eating Lab. New York: HarperCollins. 

Pollan, M. (2008). In defense of food: An eater’s manifesto. Penguin. 

Psychology. 2018. In Britannica.com. Retrieved February 13, 2018, from https://www.britannica.com/science/psychology  

SAMHSA (2017, Sept 9). Key substance use and mental health indicators in the united states: Results from the 2016 national survey on drug use and health. Retrieved from https://store.samhsa.gov/product/Key-Substance-Use-and-Mental-Health-Indicators-in-the-United-States-/SMA17-5044  

Spector, T. (2015). The Diet Myth: The real science behind what we eat. Hachette UK. 

TEDxEmory. (2013). Stephen Ilardi: Depression is a disease of civilization [Video file]. Retrieved from https://youtu.be/drv3BP0Fdi8 

Tinker, B. (2017, 21 December). US life expectancy drops for a second year in a row. Retrieved from https://www.cnn.com/2017/12/21/health/us-life-expectancy-study/index.html 

Wansink, B. (2007). Mindless eating: Why we eat more than we think. Bantam. 

Wiking, M. (2017). The Little Book of Lykke: The Secrets of the World’s Happiest People. HarperCollins.

William James. 2018. In Britannica.com. Retrieved February 13, 2018, from https://www.britannica.com/biography/William-James 

Wong, P. T. P. (2014). Meaning in life. In A. C. Michalos (Ed.), Encyclopedia of quality of life and well-being research (pp. 3894-3898). New York, NY: Springer. 

 

What To Do After Being Diagnosed With Chronic Pain

Guest Post by Ms. Waters from  Hyper-Tidy.com [Bio Found at Bottom]

When you received your diagnosis of chronic pain, you probably wondered how your life would change. That’s entirely normal, as this diagnosis can be serious. Thankfully, there are ways you can reduce your pain and increase your tolerance so you can maintain your quality of life.

But you have to be careful about prescription painkillers, as they have a dark side.

Problems With Painkillers

Many people who are diagnosed with a chronic pain condition, such as caused by rheumatoid arthritis (RA), are prescribed painkillers. However, there are problems with these drugs. As DrugRehab.org shows, more people are abusing(1) prescription drugs and becoming addicted. Some signs of painkiller addiction include losing interest in things they once loved, having erratic behavior or mood swings, an unexplained need for more money, and missing work or school.

Then what can you do if you are prescribed medication to help manage your pain? Harvard Medical School lists several tips for reducing your risk of abusing painkillers(2). First, always take any medicine as prescribed and never take more to get through tough days. Keep communicating with your doctor about how this medicine is working for you. Lastly, pay attention to yourself. If you see any signs of addiction, contact your physician immediately.

Changes To Make At Home

Even though painkillers can help you manage your chronic pain, there are other ways to improve your quality of life. One of those is to make some changes to your home and, if possible, your work.

Health.com lists several products(3) for the work and home that can help. If moving from sitting to standing causes a pain flare-up, you could use devices that raise your chair’s seat so it’s easier to use. You can even add a raiser to toilet seats to reduce pain when sitting there. Grip bars can be installed in your bathtub to make getting in and out easier and safer.

Specially designed kitchen tools like knives and jar openers can make it less painful to hold and use, while tools that extend your reach can help you get items on high shelves without stretching and triggering your pain.

A Healthier Lifestyle For Chronic Pain

Your home is not the only thing you can change to help manage your pain. There are some changes you can make to your lifestyle to help live better.

First, eating better is always a good idea, but a specific anti-inflammatory diet can help reduce the impact of your chronic pain. The Cleveland Clinic explains that you should limit your consumption(4) of simple carbohydrates, sugar, red meat, and dairy. Instead, focus on fish, turkey, and colorful vegetables like broccoli, cabbage, and bell peppers.

Secondly, exercise and meditation can also reduce your need for painkillers and improve your lifestyle. Stretching(5), weight training, and low-impact cardio exercises like an elliptical trainer can both improve your overall well-being and lessen your chronic pain. Be sure to check with your physician before starting an exercise program. And while meditation(6) will not eliminate pain, it can help you cope with your condition while making it easier for you to live with the pain you have.

Don’t Let Pain Ruin Your Days

Although living with chronic pain is not always easy, you can still enjoy your life with some adjustments. Be careful about prescription painkillers, make a few modifications at home and work, and maintain your physical health through diet, exercise, and meditation. All of this can help you live the life you deserve.

 

Author

Ms. Waters is a mother of four boys, and lives on a farm in Oregon. She is passionate about providing a healthy and happy home for her family, and aims to provide advice for others on how to do the same with her site Hyper-Tidy.com.

 

References

1 DrugRehab.org, The 45 Warning Signs of Abuse

2  Armand, Dr. Wynne; Harvard Health Publishing, The problem with prescription painkillers, Oct. 2015

3 Harding, Ann; Lee, Min-Ja; Health.com, 14 Household Tools for People in Pain; April 2011

4 Cleveland Clinic; How an Anti-Inflammatory Diet Can Relieve Pain as You Age; Nov. 2015

5 ExerciseRight.com.au; Chronic Pain and Exercise

6 Penman, Dr. Danny, Psychology Today; Can Mindfulness Meditation Really Reduce Pain and Suffering?; Jan. 2015

Therapeutic Horticulture for Mental Health

Therapeutic Horticulture for Mental Health

It has long been recognized, that positive mental health is associated with gardening and plants. This has been termed therapeutic horticulture. Cultures worldwide have made this connection for centuries, yet today, less and less time is being spent outdoors and yet more and more time is becoming sedentary. In the video above, I explore this topic, focusing on the evidence-based and research informed use of horticulture.

While therapeutic horticulture is a great coping skill to add to your tool box; it may not be that simply more green equals better mental health. Along with the mindfulness required to care for plants, the research regarding the benefit of therapeutic horticulture sheds light on a depth beyond the color of green alone.

Don’t forget to watch the video above. It’s the most work I’ve put into a video yet, and I think you will like it! Below is a summary of the information provided, you can download a pdf of this summary here: TherapeuticHorticulture Printout

What is Horticulture? 

“Horticulture is the science and art of producing, improving, marketing, and using fruits, vegetables, flowers, and ornamental plants. It differs from botany and other plant sciences in that horticulture incorporates both science and aesthetics.” (American Society for Horticulture Science, N.D.) 

Therapeutic Horticulture: The general use of plants to promote health  Horticulture therapy: The specialized, structured, goal-oriented use of plants by a therapist 
More green can equal better mental health, if used intentionally

How Plants Promote Mental Health 

However you use therapeutic horticulture, the benefit largely stems to purpose. For this reason, its not so much what is wrong with fake plants, but that the greater benefit comes from all the care that real plants require. From an occupational therapy perspective, its the “doing” that’s of value.  Below is a list of example ways you could use horticulture therapeutically. 

Direct Use: Weeding, watering, inspecting plants, harvesting  Indirect Use: Socializing, eating, tea, soup, reading, learning, writing diaries & meditative journaling, and going to a flower show 
Active Use: Sowing, germinating, potting, planting, composing beds, cultivating vegetables, and rooting various cuttings of flowers and herbs.  Passive Use: Walking, sitting near, picking flower/bouquets, watching/listening to birds, insects, butterflies, or weather 
An escape from winter, try an observatory or greenhouse

 Where to Begin 

Consider a change of scenery and get some paperwork done at an observatory or Zoo. Take a stop at your local greenhouse and wander the isles and bring a notebook or Camera.  

Easy Plants: Air Plants, Succulents, Cactus, Aloe Vera, Snake Plant, & Common Ivy   Great Places: Urban greenhouses, community allotments, water bodies, forest/woodland, countryside/farmland, wilderness 

 

If you want to grow plants, below is a couple great resources to get started!  

www.apartmenttherapy.com9 stylish houseplants (and how to not immediately kill them)

 

www.youtube.com/GardenAnswerSucculent Tips for Beginners // Garden Answer

For more information on the mental health topics I promote as an occupational therapist, read What I Teach for Mental Health

 

References 
 

American Society for Horticultural Science. (N.D). What is horticulture? Retrieved from http://www.ashs.org/?page=horticulture 

Bazyk, S. (March, 2012). From the editor. Developmental Disabilities Special Interest Section Quarterly, 35(1), 4. 

Bratman, G. N., Hamilton, J. P., & Daily, G. C. (2012). The impacts of nature experience on human cognitive function and mental health. Ann N Y Acad Sci, 1249, 118-136. doi: 10.1111/j.1749-6632.2011.06400.x. 

Clatworthy, J., Hinds, J., & Camic, P. M. (2013). Gardening as a mental health intervention: A review. Mental Health Review Journal, 18(4), 214-225. doi:10.1108/MHRJ-02-2013-0007 

Cosden M, Ellens J, Schnell J, Yamini-Diouf Y. (2005). Efficacy of a mental health treatment court with assertive community treatment. Behavioral Sciences & the Law, 23(2), 199-214.  

Diamant, E., & Waterhouse, A. (2010). Gardening and belonging: reflections on how social and therapeutic horticulture may facilitate health, wellbeing and inclusion. British Journal Of Occupational Therapy, 73(2), 84-88. doi:10.4276/030802210X12658062793924 

Eriksson, T., Westerberg, Y., & Jonsson, H. (2011). Experiences of women with stress-related ill health in a therapeutic gardening program. Canadian Journal Of Occupational Therapy, 78(5), 273-281. doi:10.2182/cjot.2011.78.5.2 

Gonzalez, M. T., Hartig, T., Patil, G. G., Martinsen, E. W., & Kirkevold, M. (2011). A prospective study of group cohesiveness in therapeutic horticulture for clinical depression. International Journal Of Mental Health Nursing, 20(2), 119-129. doi:10.1111/j.1447-0349.2010.00689.x 

Gonzalez, M. T., Hartig, T., Patil, G. G., Martinsen, E. W., & Kirkevold, M. (2011). A prospective study of group cohesiveness in therapeutic horticulture for clinical depression. International Journal Of Mental Health Nursing, 20(2), 119-129. doi:10.1111/j.1447-0349.2010.00689.x 

Parkinson, S., Lowe, C., & Vecsey, T. (2011). The therapeutic benefits of horticulture in a mental health service. The British Journal Of Occupational Therapy, 74(11), 525-534. doi:10.4276/030802211X13204135680901 

Sempik J, Rickhuss C, Beeston A (2014) The effects of social and therapeutic horticulture on aspects of social behaviour. British Journal of Occupational Therapy, 77(6), 313–319. 

Sempik, J. (2010). Green care and mental health: gardening and farming as health and social care. Mental Health & Social Inclusion, 14(3), 15-22. doi:10.5042/mhsi.2010.0440 

Wagenfeld, A. (2012, June). Health through HOrTiculture: A natural innovation. Home & Community Health Special Interest Section Quarterly, 19(2), 1–4. 

Wagenfeld, A. (2013). Nature: An Environment for Health. OT Practice 18(15), 15–19. http://dx.doi.org/10.7138/otp.2013.1815f2 

Whitham, J., & Hunt, Y. (2010). The green shoots of good health. Mental Health Practice, 14(1), 24-25. 

The Best Job Ever: Occupational Therapy in Mental Health

Picture of Coffee cups

Mental Health Occupational Therapy

Following Your Passion

First, I want you to think about a few mental health questions.

Who has ever dreamed of being an Olympic athlete?

How about a sports coach?

Personal trainer?

Or, if your like me, who of you would have been happy just being the towel or water boy?

What does this have to do with mental health? Well, the goal of this article is to share a brief picture of what occupational therapy looks like in mental health and what I do on an inpatient mental health unit. This is difficult to address without first addressing the “follow your passion” mantra. “Follow your passion” is a cultural belief common today; whether that is good or bad is another story, but the reality is, this belief exists.

It could be argued that most kids dream of being athletes and coaches because they imagine waking up for work doing what they love, which is generally sports. Similarly, it might be more common today that kids want to be video game designers and testers than athletes. Again, to wake up, go to work, and do what you love all day long.

Do you suppose if your job was to be an Olympic athlete, you would be in good shape and physically fit? Of course! If your job was to test video games, you would be great at video games too.

I played Junior Varsity basketball my Sophomore year of High School and was the only player who never scored. Sure, I was a bench warmer, but the other bench warmers still scored once in a while.

Olympic dreams crushed.

It didn’t help I never made it to 6-foot-tall, like the doctors always said I would on that little curvy graph they showed me every childhood checkup. They lied.

So maybe that’s why I gave up my Olympic athlete dreams. But was that really so bad?

A Mental Health Athlete

Now let me ask you another question: How’s your mental health doing?

When was the last time you dreamed of being a mental health athlete?

Or as that might translate better, do you find yourself wishing you were happy?

How many of you would simply like to have the energy to wake up, show up at work, or simply make it to work without hating yourself?

Well, imagine your job was to practice mental health techniques with people like an Olympic coach teaches exercise. That is just what I do and I believe all of us should value mental health like physical fitness. Coaches are not always in perfect shape, and neither am I. But I do practice what I teach. I “take my own medicine” if you will. In the same way, practicing mental health is not only for therapists like exercise is not just for Olympians.

You see, I’m an occupational therapist (OT) working in a locked, inpatient, mental health unit. This unit is focused specifically on helping young adults, which are ages 18-24ish. The primary cause for arriving to my unit is being a danger to self or others, generally from attempted suicide, suicidal ideation, self-harm, manic episodes of bipolar disorder, and active or new onset episodes of schizophrenia. Nearly everyone is a mix of these challenges and more to top it off.

Crazy right? Not so much, it turns out, one thing you would learn quickly if you spent time on an inpatient mental health unit, is the people that end up there are like you and I; students, workers, daughters, fathers, dreamers, and world travelers all the same. It’s quiet unlike One Flew Over the Cuckoo’s Nest or Shutter Island.

What’s My Role as an Occupational Therapist?

I asked you a question earlier about how your mental health was doing?

If your mental health is not doing well, then like I mentioned, you might think of the difficulty getting out of bed in the morning or getting to work, feeling fatigue and despair which makes it harder to do the things you love. Or, what you might be thinking of is more basic, the things you do on a day-to-day basis like showering or going to the store to shop for groceries.

All those “day-to-day” activities is what my profession calls “occupations” hence, occupational therapy.

By the time people end up on my unit, their “day-to-day” activities are severally disrupted by mental health that is not doing well.

If you were on the inpatient mental health unit, the most stereotypical step of the day is that staff do their best to wake you up and get you to come take your medications. Which is given with incredible effort by staff to be respectful of patients’ personal wishes and boundaries.

Then comes breakfast.

After that, comes the first of two “community meetings” in which everyone is encouraged to attend. Here staff share the schedule for the day and expectations of respect for others. I do my best to attend the majority of these morning community meetings to share what I call, my “OT schpeel.”

Which goes similar to this…

“Hi everyone, my name is Grant, I’m an occupational therapist and I lead a variety of groups here. Occupational therapy is dealing with how we ‘occupy’ time with our ‘routine’. Wake up, shower, get dressed, eat, work, talk with friends, journal or read; that’s healthy living. When mental health stops that routine, I focus on strategies to practice that routine for healthy living. If dealing with depression, coping strategies might be needed, or groups with physical activity. It might be focusing on an craft project, or simply manage the anxiety of being around others. These day-to-day activities is occupation and practicing is the therapy.”

…End of Mental Health focused OT schpeel.

Now, you may or may not have seen OT in multiple settings. Understanding the value of healthy routines to OT may make more sense when looking at OT in different settings. A school OT is addressing the school aspect of a child’s routine, the nursing home OT is helping your Grandma continuing to “do” the routine gardening she always loved while in a wheelchair.

While occupation is commonly synonymous with “vocation”, work can be apart of your routine and therefore can be something an OT would address if you had an injury or mental health challenge. However, patients on the inpatient mental health unit where I provide OT, are far more focused on getting through the day than work or school. That is why we are not addressing purely job skills. Yet, at the same time it’s important to recognize that coping skills is very much need in the work place too.

Conclusion

If you had asked me where I wanted to work, I would have never thought it was going to be mental health. Mental health was not my passion. Yet, since I’ve begun practicing all the mental health strategies and exercises I help facilitate on the unit I work, I have begun to value both OT and mental health in a new way.

In this way, I bring my positive mental health from home to work, and my skills and practice from work to home. That is why I want to share this with you.

I hope you enjoyed learning a little bit about OT in mental health. More so, I hope you are encouraged to value your mental health and not feel pressure to ignore mental health as only for the ill.

Are you interested in WHAT kinds of things we practice in OT group treatment sessions? Read my next post found at the link below:

What I Teach for Mental Health

 

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