Defining Mental Health, Purpose, and the Meaning of Life

(WARNING: This is not a short easy read article, though there will be short ones to come, this one is a part of a lengthy series)

The purpose of this article is, to delve in-depth and distinguish a clear path and strong connection from the definition of health and mental health, translated to action, in order to establish its value and meaning. I must point out, that while I explore international definitions of happiness, I emphasize its impact on the US. Most importantly however, I address the practical uses of defining health and its implications for day-to-day life. In this article, I will list several organizations that influence the US national, and also international perspectives of health, as it relates to mental health, as well as my own professional organization. These organizations are listed below in the same order they are discussed in this article, and include: 

An Introduction to Defining Health

Have you ever been diagnosed with a mental illness? Have you ever met anyone diagnosed with a mental illness? In America, it would be quite difficult to not know someone diagnosed with a mental illness. The highest rate of mental illness occurs in nearly 1 in 4 (in the past year) of those ages 18-24 (SAMHSA, 2017). Trailing closely behind the young adults, are the rates of those ages 25-49. It’s not an age or generational thing. The percentage of those with a mental illness, or multiple, is increasing across all generations with no sign of stopping. 

But have you ever wondered if anything about the whole mental health situation is strange? Have you ever wondered about questions such as: 

  • Does everyone really have a mental illness? 
  • At what point do you consider something a mental illness? 
  • Are more medications really the answer? 
  • Was I actually born this way? 
  • Can it be cured, or do I have to live with this the rest of my life? 
  • Why, with all our medical advances and healthcare costs, are rates increasing? 

It seems the public culture in the United Kingdom (UK) is picking up on this healthcare epidemic faster than the United States (US) demonstrated by the organization now holding events called A Disorder For Everyone! There is growing momentum towards changing the definition of diagnosis altogether, of which several examples, I will list in this article.  

Unfortunately, I believe most of these changes are just trading in one set of carrots, for another set of carrots to chase. I do not believe the solution is complex, in fact, I believe it is quite simple. 

A Conjecture For Everyone

 

Definition of conjecture:

1a : inference formed without proof or sufficient evidence

  • b : a conclusion deduced by surmise or guesswork   

It seems difficult to make a useful conjecture in today’s opinion infatuated age, but then maybe it has always been difficult to make conjectures. Maybe the difficulty with conjectures is defining at what point “sufficient evidence” evolves a conjecture to something more.  

I have not been an effective consistent producer of writing because I have a desire to escape conjecture for grounded, evidence-based, quality writing. Yet, I find myself extensively deep with books and journal articles into topics such as mindfulness, focus, self-esteem, motivation, goal setting, mental health, and change, with more questions than when I began.  

Today, I shall break this cage of conjecture-fear for a 3-point thesis statement: 

  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.  

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. This is to say, without digressing further; a drug dealer may have great mental health, while someone with no diagnosis may have poor mental health, even worse than those deemed “mentally ill” by medical standards. Specifically, purpose and mental health, is not the pursuit of “happiness.” One could define happiness as their purpose, but their mental health would still be related to the ability to pursue it, not the happiness itself. The difference being; purpose and positive mental health can exist without happiness, or even well-being, as I shall argue. 

This perspective was echoed long before my time, by Viktor Frankl in his book Man’s Search for Meaning (1946). Frankl states “Man’s search for meaning is the primary motivation in his life and not a “secondary rationalization” of instinctual drives.” (pg.105) and continues to say “This meaning is unique and specific in that it must and can be fulfilled by him alone; only then does it achieve a significance which will satisfy his own will to meaning.” (pg.105) 

Viktor Frankl was a psychiatrist who survived the Holocaust, including Auschwitz.  Afterwords, he developed a Psychotherapy termed Logotherapy. Frankl describes the emphasis on meaning in relation to mental health in Logotherapy when he stated: 

“According to Logotherapy, this striving to find a meaning in one’s life is the primary motivational force in man.”  

I believe as a culture both national and international, we have forgotten the value of meaning and purpose as primary determinates of health. Instead we have come to as Merriam-Webster reflects in the first definition of each word below, an unrealistic, hopeless, and demoralizing standard:  

Definition of well-being : the state of being happy, healthy, or prosperous : welfare

Definition of health : 1 a : the condition of being sound in body, mind, or spirit; especially : freedom from physical disease or pain

Definition of welfare : 1 a : the state of doing well especially in respect to good fortune, happiness, well-being, or prosperity

As for an argument that this so called state of “health” is not achievable; I argue, has it truly ever been achieved? When you boil down the definition to it’s roots, I argue “the state” of welfare is superficial way to describe a happiness-filled immortality. If not, then how much longer must we wait? Secondly, particularly in America, the standard of living has increased to amazing proportions. Yet, despite this, in the US there 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) 

To provide the foundations for one other cornerstone assumption guiding my perspective in writing this article, is evidence supporting the idea that meaningful life can be lived by those with mental illness. I must first ask; do you think those with mental illness can live meaningful lives? If so, why? I am not arguing we should forget the suffering of those with mental illness and stop treatment. I am arguing that treatment itself may either be in most cases, not effective, worsening the problem, or engraining in society the idea that those with mental illness are broken until “fixed and free of suffering.” Lastly, what sufficient proof do we have that there is scientific and grounded evidence for deeming all those mentally ill as, mentally ill? I shall use one example, though I could use many, for this point.  

Recovering from Schizophrenia 

I chose schizophrenia for this point, because as Jobe and Harrow (2005) explain it, “schizophrenia patients as a group show poorer outcome than patients with other types of psychiatric disorders; in this sense, schizophrenia is a poor-outcome disorder.” Yet even with this poor-outcome disorder and a strict sense, and as I argue, terrible sense, of how recovery has historically been defined, Jobe and Harrow (2005) state “only 16.3% of subjects with schizophrenia and 35.8% of subjects with other psychoses in the incidence groups qualified as recovered. Even using the strictest criteria for recovery, there remained some level of symptoms and disability among some recovered patients.” 

By modern definitions of health then, while recovery may have been possible for a select few of those with schizophrenia in these studies, there would be a near 0% chance of achieving health and well-being, so long as health and well-being included having no level of symptoms and disability. 

However, Two counter-cultural and hard to understand themes emerged throughout the conclusions of several of these systematic and longitudinal studies: 

  • Those with schizophrenia have higher rates of positive outcomes in less developed countries (Jobe & Harrow, 2005; Jääskeläinen et al., 2013). 
  • There is a large population of those with Schizophrenia who gave up on medication and treatment and recovered better than those that didn’t stop receiving “help” (Davidson et al., 2007; Harrow & Jobe, 2007). 

This is not sufficient evidence to declare all medication and mental health treatment is fraudulent and worth stopping, which is not what I believe. For those with Schizophrenia, there were other factors influencing the success rate of those that “gave up” on treatment. Then again, of the influencing factors supporting recovery, was the lack of time on medications and in treatment. This implies the correlation (not causation); the longer a person received treatment, the more dependent upon it they become (Davidson et al., 2007; Harrow & Jobe, 2007). These are however, among a great multitude of studies that demonstrate that there is a sense of “learned helplessness” and poor definitions of what recovery is, or at least what recovery is needed to live meaningful and purposeful lives. My point is summarized by Davidson et al., (2008) when stating people with a poor-outcome disorder such as schizophrenia are by many means, still able “to live meaningful and gratifying lives in the face of an enduring mental illness.” 

 

The Influential Organizations That Define Health

 

The World Health Organization (WHO) 

 The World Health Organization (WHO) is arguably, the primary influence on national and international healthcare, as well as cultural perspectives, on the definitions of health, mental-health, and general well-being. Why WHO is arguably the primary influence, is that the following organizations use or derive their definitions from WHO. 

 My own professional organization, the American Occupational Therapy Association (AOTA), also derives its definitions of health from WHO (AOTA, 2014). Again, there are aspects I can greatly appreciate in the definitions provided by WHO, yet I argue there are fundamental errors that negate the whole understanding of mental health as we know it today.

Interestingly enough, the constitution of the WHO was adopted in the same year Viktor Frankl published his book Man’s Search for Meaning, which was 1946 (Frankl’s quotes used in this article come from a later version printed in English in 1959). Considering WHOs constitution was written the same year immediately after World War II, it’s quite an advancement for international human rights, given the atrocity and devastation of World War II.

Unfortunately, it seems Frankl’s value of “meaning” did not influence WHO’s constitution at its inception, enough, though the constitution would have benefited from it. While the principles were possibly effective at the start, it is time we either change the definitions of “well-being” and “health” or change the constitution itself. WHO lists an entire 9 principles in their guiding constitution, of which I list the first two below: 

Constitution of WHO: Principles 

  1. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” 

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” 

I do greatly appreciate this idea that health is “not merely the absence of disease or infirmity.” Unfortunately, as its used; it seems that anyone with disease or infirmity can only enjoy the “highest attainable standard of health” at some lower level than those without disease or infirmity. Yet who can live a life without disease or infirmity? Let health be measured in dedication to purpose.  

Without digressing into the negative impacts of the highlight reel phenomenon that occurs with the current use of social media; comparisons matter. Meik Wiking, the CEO of The Happiness Institute and author, points out in his TED talk The Dark Side of Happiness, that despite having arguably the world’s highest standard of living in Denmark, suicide rates rank Denmark at average globally (TEDxCopenhagen, 2016). His point: comparisons matter. When everyone else is supposedly happy and working, then not having that experience can be incredibly demoralizing. Yet, if the definition of health is expected to be at the extreme end of constant happiness and well-being, we compare ourselves to unrealistic, unachievable, fictional expectations. 

I do not believe health as a state of “complete physical, mental and social well-being” will ever be achievable. In fact, the belief that this is a noble cause is, in my opinion, a major contributor to poor mental health and mental illness. Again, while the words and terminology may differ, this idea of “free from suffering” is blatantly, a guiding vision of what health is supposed to be as directed by science and the medical community, which will be a remerging point of contention throughout this article. 

 

 

Center for Disease Control and Prevention (CDC) 

 In the United States, the Center for Disease Control and Prevention (CDC), directly cites their definitions by WHO.  Maybe the words don’t matter to some, and it’s all opinion. Yet, I believe there is a great and notable problem with these definitions. They all imply that those with mental illness, which are those labeled and diagnosed, cannot achieve “health” until medically shedding the label or diagnosis. If one is unable to medically shed the label or diagnosis, then your life, as WHO or simply stated, “the world”, is merely measured in your ability to achieve the “highest attainable standard of health” at some second best, second rate level. No wonder people are so afraid of being diagnosed, and so desperate for a cure! In many ways, the world defines health as not being diagnosed 

 An often-cited book of great value, written by scientist and researcher, Carol Dweck, titled Mindsets (2006), address this cultural battle of perspectives. Dweck argues we need to practice the growth mindset rather than the fixed mindset. 

Pg.6 Believing that your qualities are carved in stone – the fixed mindsetcreates an urgency to prove yourself over and over. If you have only a certain amount of intelligence, a certain personality, and a certain moral character – well, then you’d better prove that you have a healthy dose of them. It simply wouldn’t do to look or feel deficient in these most basic characteristics. 

Pg.7 This growth mindset is based on the belief that your basic qualities are things you can cultivate through your efforts. Although people may differ in every which way – in their initial talents and aptitudes, interests, or temperaments – everyone can change and grow through application and experience.

Dweck does NOT argue those with the growth mindset will not experience mental illness or depression. However, her research did find that “…students with the fixed mindset had higher levels of depression” (Dweck, 2006). Of value is her earlier point that, with fixed mindset behaviors, we believe we have certain qualities that cannot be changed, so we try to “prove” what we have and don’t have. Thus, in a world defining your health and standard of living as having or not having mental illness, we try to prove or disprove what we have or do not have, rather than addressing our actual needs regardless. This is simply, a classic division of the haves and have-nots. The world, says you are either born healthy, or born destined to be not healthy. That is, unless, “SCIENCE CAN FIND A CURE” and as T. Collin Campbell argues in his book Whole (Campbell & Jacobson, 2013), “BANISH UNPREDICTABILITY.” This of course, comes at the price of an endless supply of increasing research funds, medical bills, medications, and of course, your hope.   

I am not arguing that the practice of science and research is bad, nor the use of medications. These can be wonderful things. What they are not, is an answer to life, purpose, meaning, or health. We should not place our hope in science, research, or medicine. We should not allow lives to be defined be these things.  

To reinforce the influence of one organizational definition on another, I have listed below, what Mental Health is, as found on the CDC website, as well as the CDC mental health indicators as based on their own research. 

What is mental illness? 

Mental illnesses are conditions that affect a person’s thinking, feeling, mood or behavior, such as depression, anxiety, bipolar disorder, or schizophrenia. Such conditions may be occasional or long-lasting (chronic) and affect someone’s ability to relate to others and function each day. 

What is mental health? 

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood. 

Although the terms are often used interchangeably, poor mental health and mental illness are not the same things. A person can experience poor mental health and not be diagnosed with a mental illness. Likewise, a person diagnosed with a mental illness can experience periods of physical, mental, and social well-being (CDC, 2016). 

Mental Health Indicators 

Researchers suggest that there are indicators of mental health, representing three domains. (citations 6-8). These include the following:  

  • 1. Emotional Well-being: Such as perceived life satisfaction, happiness, cheerfulness, peacefulness. 
  • 2. Psychological well-being: Such as self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships. 

3. Social well-being: Social acceptance, beliefs in the potential including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships.  

These may be indicators in sum. But as I made the statement earlier, I believe mental health can exist outside of the majority of these definitions. The most useful of the terms listed include “purpose in life”, “hopefulness” and possibly “positive relationships.” This is to say, I am not arguing against all means of defining mental health or the indicators of it. I am arguing against the idea of mental illness being so fully defined by “happiness” or “the absence of mental illness.”

 

Substance Abuse and Mental Health Service Administration (SAMHSA) 

 I must appreciate, in a positive light, a more fruitful definition of mental health. Or, as the Substance Abuse and Mental Health Service Administration (SAMHSA) advocates for; Recovery. SAMHSA’s sense of mental health defined as Recovery is listed below: 

 “Working definition of recovery from mental disorders and/or substance use disorders: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” 

SAMHSA, in their 10 Guiding Principles, explains hope “That people can and do overcome the internal and external challenges, barriers, and obstacles that confront them”   (SAMHSA, 2012), which is similar to Carol Dweck’s Growth Mindset. Again, as terms change, ideas and meaning can be similar. As I argue for valuing purpose, many of these ideals are described by SAMHSA’s person-driven point as stated “define their own life goals and design their unique path(s) towards those goals” (SAMHSA, 2012). The use of goals in this sense, is similar and related to how I use prioritization in my initial thesis conjecture at the beginning of this article. 

 Previously, I just listed SAMHSA’s principles of recovery to reflect their guiding beliefs behind health. Below are what SAMHSA has identified through its research sources, as the ingredients for recovery called the Four Major Dimensions: 

  • Health—overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem—and, for everyone in recovery, making informed, healthy choices that support physical and emotional well-being 

    Home—having a stable and safe place to live 

    Purpose—conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society 

    Community—having relationships and social networks that provide support, friendship, love, and hope 

 I list all these, not to the ease of any readers of this article. Rather, I have determined it necessary for my own sanity, to begin a more comprehensive approach to addressing topics related to mental health. It’s difficult to write articles on topics such as mindfulness, goal setting, horticulture, coping skills, and other positive mental health practices, without first clarifying where they all fit into the greater picture of health and life itself. The effort of this article, is to provide several lists and sources of the major influences on what defines our national and international perspectives of health. While I certainly give my own opinion and perspective on the value of these definitions, I have found it necessary personally, to be able to see several in order to weigh and evaluate. I hope in the same way, regardless of my opinion, you too, can find a wholistic and comprehensive expression of health, possibly informed by the resources listed. 

 

 

 

The National Alliance on Mental Illness (NAMI)  

The National Alliance on Mental Illness (NAMI) is an insightful resource and valuable organization to the US public, in understanding and moving forward. I will not discuss NAMI in depth, as it’s definitions, though not directly stated, are derived near verbatim, from WHO and SAMHSA (NAMI, 2018). However, despite my argument against WHO’s definitions, I still value NAMI as a patient empowering and resource providing approach, and I highly recommend visiting their website to browse. I agree with NAMI’s interpretation:  

Recovery, including meaningful roles in social life, school and work, is possible, especially when you start treatment early and play a strong role in your own recovery process.” 

 

 

The National Institute of Mental Health (NIMH) 

The National Institute of Mental Health (NIMH) is another leading organization, though it’s role is primarily involved in research, and reflects and cites SAMHSA and the CDC for their definitions and statistics.

 In a recent article by NIMH titled Different Approaches to Understanding and Classifying Mental Disorders (NIMH, 2017), the entire concept of diagnosis itself is challenged by leading US researchers and scientists themselves (Clark et al., 2017). NIMH points out “three existing approaches” to how individuals are diagnosed with mental illness listed below.  

 The three existing approaches— 

  • the International Classification of Diseases (ICD),  
  • the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the  
  • National Institute of Mental Health (NIMH)’s Research Domain Criteria (RDoC) 

 “…these systems often result in comorbid diagnoses (i.e., when people are diagnosed with multiple disorders at one time), and are sometimes criticized for the seemingly arbitrary boundaries they set between disorders and nondisorders. 

According to Dr. Cuthbert , “we now understand that the categories are not specific diseases (like Lyme’s Disease or influenza) but rather are broad syndromes – loose collections of symptoms that tend to occur together to some extent, and involve dysregulation in multiple domains.”  (NIMH, 2017).

 The first two current approaches called the ICD and DSM are summarized as “outdated.” The new approach that NIMH calls Research Domain Criteria (RDoC), will be a “different way to conceptualize mental disorders” that will not be “bound by specific categories or classifications of disorders or by thresholds of diagnosis”  (NIMH, 2017). While this sounds like a step in the right direction, is it not disheartening to recognize that our entire cultural conception of mental illness, as I have argued throughout this article, is going to be changed simply because of “what we now understand”?

I return to my point regarding reductionist science, and the ever-eluding hope of a cure. Science and research are, maybe helpful things; but it’s chasing a carrot. Time and time again, we will return to a point of “what we now understand.” Is it worth experimenting with the increasing suicide rates and futures of the next generation? Is it all worth our hope, meaning, and purpose? All for scientific advancement and medicine? I argue simply, we will never be “free from suffering” and we will never “banish unpredictability. Therefore, no “better classification” of mental illness, will fix our suffering. This is NOT to say, that classifications, medicine, science, or research, are themselves the problem. Instead, this is to reiterate the problem of defining health, purpose, and the value of life, on the “lack of illness” or Merriam-Webster’s definitions of health, well-being, and welfare. 

 

 

The British Psychological Society 

 In addition to the US based organization NIMH, which is soon proposing the new  Research Domain Criteria (RDoC) approach to mental illness instead of the historical DSM diagnosis, there is also a UK based proposition. This UK based proposition is called the ‘Power Threat Meaning Framework’ described in a 2018 publication by the British Psychological Society (Johnstone et al., 2018). In their article, the authors explain: 

 Power Threat Meaning Framework 

 “The Framework invites psychologists to understand distress and troubling behavior as the product of life experiences as they impact upon embodied people” 

He reports “the main aspects of the Framework are summarized by a set of questions which can be applied to individuals, families or social groups:

1. ‘What has happened to you?’ (How is power operating in your life?)

2. ‘How did it affect you?’ (What kind of threats does this pose?)

3. ‘What sense did you make of it?’ (What is the meaning of these situations and experiences?)

4. ‘What did you have to do to survive?’ (What kinds of threats response are you using?)

This work, was in fact influenced by Viktor Frankl’s Logotherapy, which I described at the beginning of this article, among several others. I appreciate most the “what sense did you make of it?” Component of the framework. What has happened to you, does possibly over emphasize the component we in America perseverate on known as “trauma.” However, as Carol Dweck (2006) points out in Mindset, there is strong evidence that implies having even 1 positive relationship is more influential than trauma, on the outcome of a person. While reflection may be necessary in the process of finding purpose, I worry that placing too much focus on that component will not over-turn the “learned helpless” that I have argued against with the implications of current standards of Health. Instead, I argue for greater inclusion of the growing concept; it’s not “what’s the matter with you?” But rather “what matters to you?” This appears to have come first from Barry & Edgman-Levitan (2012) in their article Shared decision making—the pinnacle of patient-centered care and advocated for by UK based Institute for Healthcare Improvement.  

 

 

The International Self-Care Foundation (ISF) 

 “The International Self-Care Foundation (ISF) is a registered UK Charity with a global focus.” 

“ISF’s Vision: is of a world in which people live long healthy lives, taking personal responsibility for their own wellness by adopting healthy lifestyle and self-care behaviours.” 

 I argue, ISF’s definition exemplifies a few of the primary misconceptions about mental health. Though much in the debate of mental health is related to definitions and words that carry different meaning across cultures, I believe the fundamental elements of error remain the same. Words such as “long healthy” and “wellness” are broad and vague, but also eventually, despite more noble sounding words, relate primarily to a medically defined form of “happiness.” This then, being the idea of always being “free from suffering”, which is evident despite any variance in the terminology or meaning.  

One author of several, to which I shall return to many times in the next few comprehensive articles I have already written like this one, is the scientist and researcher T. Collin Campbell who wrote the book Whole. In his book, Campell argues against the current state of science, being a practice of trying to solve all the variables to achieve some type of enlightenment, somewhere in a fantasy future. He argues instead, science can look at the big picture of what already works in a Wholistic approach. Instead, many cultures have lived long healthy lives before modern medicine. Longer lives than we live in American today. Instead, Campbell argues, we should emulate and study them, instead of studying what is wrong with us. I believe he captures the essence of my argument against “happiness and health” being the idea of “free from suffering” when he states: 

“What we really want from science is an end to randomness. We want to know why diseases strike some people and not others. We want to know how to protect ourselves against the scourges that have our names on them. We want, in short, to banish unpredictability.” – T. Collin Campbell 

Put simply; we want to be God. 

 As I move forward in this article, I still want to share a few comprehensive lists provided by leading and influential organizations, as they define mental health. Again, terms vary such as  

  • wellness,  
  • well-being,  
  • health,  
  • mental health,  
  • self-care 
  • happiness, etc.  

 Yet I believe the picture and idea that many of these organizations, and most people influenced by culture, have on what this “health” is supposed to look like, is the same. Regardless, I still appreciate an attempt to begin to break down valuable components of health. I do not believe engaging in these practices to achieve health will allow any individual to achieve health. What I do believe is, the ability to focus on priority, which is purpose, is health. In which case, having these lists, can certainly help someone make informed prioritizations. The “7 Pillars” as the ISF lists them are: 

  1. 1. Health literacy – includes: the capacity of individuals to obtain, process and understand basic health information and services needed to make appropriate health decisions 

2. Self-awareness of physical and mental condition – includes: knowing your body mass index (BMI), cholesterol level, blood pressure; engaging in health screening. 

3. Physical activity includes– practicing moderate intensity physical activity such as walking, cycling, or participating in sports at a desirable frequency. 

4. Healthy eating – includes: having a nutritious, balanced diet with appropriate levels of calorie intake. 

5. Risk avoidance or mitigation – includes: quitting tobacco, limiting alcohol use, getting vaccinated, practicing safe sex, using sunscreens. 

6. Good hygiene – includes: washing hands regularly, brushing teeth, washing food. 

7. Rational and responsible use of products, services, diagnostics and medicines – includes: being aware of dangers, using responsibly when necessary. 

 In defining self-care, the ISF does clarify its own purpose as not for “practical uses” but instead for “policy and spending in order to change behaviour at a population level.” However, I believe this step away from “practical” is what makes health care extremely costly, while also failing to meet the needs of the human condition at the basic level of finding meaning and purpose (Webber, Zhenyi, & Mann, 2013). However, the self-care pillar 7, provides an often missed component of healthcare; using medical-care appropriately. Though, what is deemed appropriate then becomes quite debatable. 

 

 

The Happiness Research Institute  

I was Inspired to review this resource, after the organizations CEO, Meik Wiking, gave his TED talk The Dark Side of Happiness  (TEDxCopenhagen, 2016). While not affiliated with a government agency, this literature produced by the Happiness Research Institute is non-the-less, valuable. In fact, its place in this article may be more valuable, because of its independent status. Of its publications, is the World Happiness Report (Helliwell, Layard, &  Sachs, 2017). They explain their purpose; “(pg.9) Its central purpose was to survey the science of measuring and understanding subjective well-being.” Technically, the definitions for the purposes of this article, are stated in the report, to be from The Organization for Economic Co-operation and Development (OECD). The OECD Guidelines on Measuring Subjective Well-being (2013, p.10) is listed below:  

“Good mental states, including all of the various evaluations, positive and negative, that people make of their lives and the affective reactions of people to their experiences…. This definition of subjective well-being hence encompasses three elements: 

Life evaluation—a reflective assessment on a person’s life or some specific aspect of it. 

Affect—a person’s feelings or emotional states, typically measured with reference to a particular point in time. 

Eudaimonia—a sense of meaning and purpose in life, or good psychological functioning.” 

The report describes the paradox I stated at the beginning of this article; that while the American standard of living is increasing, health and happiness are decreasing, and mental illness has a specific role in this (Easterlin 1964; Easterlin, 2016; Helliwell, Layard, & Sachs, 2017). As Sachs states it at the end of the report “America’s crisis is, in short, a social crisis, not an economic crisis”, he goes on to say “In sum, the United States offers a vivid portrait of a country that is looking for happiness “in all the wrong places” Helliwell, Layard, &  Sachs, 2017). My argument is, that those “wrong places” is looking for happiness in happiness itself.  However, this report is useful in light of the OECD’s definitions of life evaluation, affect, and eudaimonia. If anything, eudaimonia reflects the epitome of what I would consider health. Life evaluation, then would be the belief that one had health. I believe the US culture, on top of already over emphasizing the value of happiness itself, especially confuses affect with happiness. Affect being the experience of emotions from Joy to Sadness. Truthfully, a healthy life should include or not limit sadness.  

 Yet one might argue against my point that “it’s not sadness that’s the problem, it’s chronic, lasting, long-term sadness that’s the sign of mental illness.” Also then, the current state of medicine implies, that this chronic, lasting, long-term sadness, is the result of ” a variety of factors” but mostly “genetic and biological factors”, “trauma”, “social pressure”, “poverty” and “chemical imbalances”, which is ultimately mental illness. Which is again to imply, those born into mental illness are broken, unfixed, and unhealthy, until all those other barriers are removed; which will likely not be removed in any near lifetime.

 I contend here, that in fact, chronic, lasting, long-term sadness, is rather, in large (but not entirely), a result of the misdirection of cultural values and understanding of what health is. That is to say simply, a good part of the problem is the problem itself. The engrained belief system of mental illness and what it determines. That ultimately, the broad and large scale answer, is to revert our belief back to; a purpose-driven health. 

 

 

American Occupational Therapy Association (AOTA)

Within my own profession, health, well-being, participation, and engagement in occupation, are defined as the World Health Organization (WHO) presents them. To which I have previously given my opinion. Yet, I am thankful to work for the profession I do, as an occupational therapist. One of the primary defining documents by the American Occupational Therapy Assocation known currently as the 3rd Practice framework, states:  

 “Achieving health, well-being, and participation in life through engagement in occupation is the overarching statement that describes the domain and process of occupational therapy in its fullest sense.”

 While I have thus disagreed with the current definitions of health and well-being, I appreciate the value that occupational therapy gives to “participation in life through engagement in occupation.” This idea does revert back to the emphasis on meaning and purpose. Occupation as occupational therapy uses it, I believe, are best explained by these two (of several) definitions listed in the 3rd Practice Framework. 

“In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do” (World Federation of Occupational Therapists, 2012). 

 “Goal-directed pursuits that typically extend over time, have meaning to the performance, and involve multiple tasks” (Christiansen et al., 2005, p. 548). 

 In the two definitions listed above, are the words and phrases “meaning and purpose to life” and “pursuits…have meaning to the performance.” This is where I begin to value the work I do. In my own efforts to seek purpose and find meaning, I find it equally important to do the work that also supports this perspective. It is my job to support others in, as my professional organization states, “achieving health, well-being, and participation in life through engagement in occupation.” To do this, I find it all the more important, to know what health, well-being, and life itself is.  

 

 

What Then is, Positive Mental Health? 

Positive mental health is “not merely the absence of disease or infirmity” but arguably also, neither is mental illness the addition of “disease or infirmity.” 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. Quality of life should not be measured by the absence or even reduction of suffering for comfort, but rather for the addition of purpose and meaning.  

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 directs, is the act of prioritization. Therefore, positive mental health behavior, is taking any action to focus on positive priorities. The way I argue, this impacts day to day life is: You must first identify your purpose or else identify what you’re willing to prioritize. Neither of these elements have to be fully framed, but are likely to be an organic growing process. What you focus on and prioritize, informs purpose, and that purpose, should also inform what you prioritize.  

Someone might argue,  

“Well how do I know what my purpose is? That is too complicated, too large a task to figure out, and even anxiety producing itself.”  

Here then, I respond, it may not be fully realized upon first attempt, but the human must move. That is to; move in body and thought. Certainly, while not scientifically backed or evidence based, I make the conjecture; that at least beginning to contemplate your purpose cannot be more overwhelming than attempting to organize what health behaviors you should begin with, given the enormous variety of often contradicting ideas provided by modern medicine.

If some, even the faintest amount, of purpose is identified first, then those positive health behaviors fall into place. Ideally one at a time, with a downstream effect on the others. That is to say, if your greatest purpose was to “spend time with my grandkids”, then exercising so that you can have the energy to do so becomes only a part of your health, but not the sole determinant of your health. If purpose was to “pursue God”, then a good sleep schedule to begin the day in prayer may be necessary.  

How this influences day-to-day health behavior change is, as explained by Stephen Covey (1989) to “Put first things first.” 

That leaves the health factors such as those listed below, valuable informers of what behaviors could contribute to your purpose. To conclude the primary heath factor lists covered in this article are: 

  • 7 Pillars of Self-Care by ISF 
  • Mental Health Indicators by CDC 
  • The 4 Major Dimensions by SAMHSA  

 One thing I have learned through the development of this article, is recognizing just how far a thread can be pulled. For example, one might see a popular magazine site publish a trending article on mental health. This article in turn, cites another popular website article such as Psychologytoday.com, as its source of information. If you go to that next article for that source of information, it may cite the CDC as its source. If you then continue clicking the links, and go to the CDC website, you might find that the CDC cites NIMH as its source. NIMH then cites the WHO as its source, and WHO then cites a series of articles as it source. Even yet, if you click the peer-reviewed research articles and take the effort to find them on a database and read them as I have, they might be a meta-analysis of a series of other articles to which the primary information was produced. To which you would then, need to pull up the original article, which is often decades or more, old.  

That is the problem with waiting for science and medicine alone, to fix our problems. It takes decades for information to catch up with us. By the time science and medicine does “catch-up”, it’s often outdated and irrelevant to current needs. Which is why, I believe, the true answers, as I will discuss in future articles, are always – simple. These simple answers, I believe, go unchanged through the course of human history. Things that go unchanged; are truths.  

 

 

Conclusion: The Next Step

I postulate, the deep wounds, hurt, and fear, that exist in society today regarding addressing mental illness thus relates to the emphasis we place on responsibility, change, willpower, and fault. 

It is no wonder an epidemic of depression exists; if we are all told our meaning in life is to be free of suffering.  What disappointment often comes to those that try; for what they expect as a product and outcome of their vulnerable effort to change at all. It is thought that happiness is the product of positive mental health. Though I believe the reality is for many, happiness is an experience often far and in-between.  

We as humans share a common experience. To be awoken in the midst of a wreckage we call life. We see our ancestors floating away as if taken by the ocean tide. They are all gone before we can ask enough questions, but, if we could ask all the questions in the world, they wouldn’t have them all.  We don’t know who or what to blame, and guilt can so easily overcome us, as though we were brought here by the fault of each of our own individual decisions to become suddenly awoken to consciousness and birthed. So how then do we make use of our situation? 

I return to my thesis statement:

  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 live a meaningful life, is to focus with blistering intensity on the right priorities for the right purpose. Of what is right, is for debate, but our responsibility to take action for change, if we are to find purpose and meaning, is not. This will be done through effective delegating of automatic behaviors to habit and intentional efforts to willpower. We have limited reserves of time, attention, and willpower. How we harness these three elements determines where our focus goes. Intentional use of habit and willpower determines what we focus on, which determines our priorities, which ultimately, determines our purpose and meaning.  

Let’s not blame each other for the past misuse of time, attention, and willpower that we have each been allotted. Let’s not give up on purpose yet. Let’s keeping trying, together, today.  

“Woe to him who saw no more sense in his life, no aim, no purpose, and therefore no point in carrying on. He was soon lost.” (pg.85) by Viktor Frankl in his book Man’s Search for Meaning (1946) 

 

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 

Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781. 

Campbell, T. C., & Jacobson, H. (2013). Whole: rethinking the science of nutrition.  Dallas, TX; Bella Books.  

Center for Disease Control and Prevention. (2016, May 31). Well-Being Concepts [webpage]. Retrieved January 4, 2018, from https://www.cdc.gov/hrqol/wellbeing.htm 

Center for Disease Control and Prevention. (2017, June 28). Chronic disease overview [webpage]. Retrieved January 4, 2018, from https://www.cdc.gov/chronicdisease/overview/index.htm  

Center for Disease Control and Prevention. (2018, January 26). Learn About Mental Health [webpage]. Retrieved January 4, 2018, from https://www.cdc.gov/mentalhealth/learn/index.htm 

Christiansen, C., Baum, M. C., & Bass-Haugen, J. (Eds.). (2005). Occupational therapy: Performance, participation, and well-being. Thorofare, NJ: Slack.  

Clark, L. A., Cuthbert, B., Lewis-Fernandez, R., Narrow, W., Reed, G. (2017). Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the national institute of mental health’s research domain criteria (RDoC). Psychological Science in the Public Interest, 18(2), 72-145. doi: 10.1177/1529100617727266 

Conjecture. 2018. In Merriam-Webster.com. Retrieved January 4, 2018, from https://www.merriam-webster.com/dictionary/conjecture 

Covey, S. (1989). The seven habits of highly successful people. Fireside/Simon & Schuster.

Cromby, J. (2013, January 30). An alternative to psychiatric diagnosis? Retrieved from https://www.psychologytoday.com/blog/the-bodies-we-re-in/201801/alternative-psychiatric-diagnosis 

Davidson, L., Schmutte, T., Dinzeo, T., & Andres-Hyman, R. (2007). Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophrenia Bulletin, 34(1), 5-8. 

Davidson, L., Schmutte, T., Dinzeo, T., Andres-Hyman, R. (2008) Remission and recovery in schizophrenia: Practitioner and patient perspectives, Schizophrenia Bulletin, (34)1, 5–8, https://doi.org/10.1093/schbul/sbm122 

Dweck, C. (2006). Mindset: The New Psychology of Success. New York, NY: Ballantine Books. 

Easterlin, R. (1964). Does economic growth improve the human lot? Some empirical evidence. P. A. David & W. R. Melvin (Eds.), Nations and households in economic growth: Essays in honor of moses abramovitz, (pp. 89-125). New York, NY: Academic Press 

Easterlin, R. (2016). Paradox lost? USC dornsife institute for new economic thinking, working paper No. 16-02 

Frankl, V. E. (1959). Man’s Search for Meaning. Boston, MA: Beacon Press 

Harrow, M., & Jobe, T. H. (2007). Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: a 15-year multifollow-up study. The Journal of nervous and mental disease, 195(5), 406-414. 

Health. 2018. In Merriam-Webster.com. Retrieved February 4, 2018, from https://www.merriam-webster.com/dictionary/health 

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

International Health Conference. (2002). Constitution of the World Health Organization. 1946. Bulletin of the World Health Organization, 80(12), 983–984. 

International Self-Care Foundation. (2018). ABOUT ISF [Webpage]. Retrieved January 4, 2018, from http://isfglobal.org/about-isf/ 

Jääskeläinen, E., Juola, P., Hirvonen, N., McGrath, J. J., Saha, S., Isohanni, M., Veijola, J., & Miettunen, J. (2013) A systematic review and meta-analysis of recovery in schizophrenia, Schizophrenia Bulletin, 39(6),1296–1306, https://doi.org/10.1093/schbul/sbs130  

Jobe, T. H., & Harrow, M. (2005). Long-term outcome of patients with schizophrenia: a review. The Canadian Journal of Psychiatry, 50(14), 892-900.  

Johnstone, L. & Boyle, M. with Cromby, J., Dillon, J., Harper, D., Kinderman, P., Longden, E., Pilgrim, D. & Read, J. (2018). The Power Threat Meaning Framework: Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis. Leicester: British Psychological Society.  

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. 

National Alliance on Mental Illness. (2018). Mental health conditions [Webpage]. Retrieved January 4, 2018, from https://www.nami.org/Learn-More/Mental-Health-Conditions 

National Institute of Mental Health. (2017, December 27) Different approaches to understanding and classifying mental disorders. [Webpage] Retrieved January 4, 2018, from https://www.nimh.nih.gov/news/science-news/2017/different-approaches-to-understanding-and-classifying-mental-disorders.shtml 

Substance Abuse and Mental Health Service Administration. (2012). SAMHSA’s working definition of recovery: 10 guiding principles of recovery. Retrieved from https://store.samhsa.gov 

Substance Abuse and Mental Health Service Administration. (2017). 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  

TEDxCopenhagen. (2016, May). Meik Wiking: The dark side of happiness [Video file]. Retrieved from https://youtu.be/PbtzY-8IFTQ 

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 

Webber, D., Zhenyi, G., & Mann, Stephen. (2013). Self-care in health: We can define it, but should we also measure it? SelfCare 4(5): 101-106 

Welfare. 2018. In Merriam-Webster.com. Retrieved January 4, 2018, from https://www.merriam-webster.com/dictionary/welfare 

Well-being. 2018. In Merriam-Webster.com. Retrieved January 4, 2018, from https://www.merriam-webster.com/dictionary/well-being 

World Federation of Occupational Therapists. (2012). Definition of occupation. Retrieved from http://www.wfot.org/Aboutus/aboutoccupationaltherapy/definitionofoccupationaltherapy.aspx 

 

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. 

How Being A Parent Has Helped Me As A Therapist

You missed it - sorry

My work as an Occupational Therapist has it’s benefits. I work specifically in mental health with young adults ages 18-24. However, many often associate occupational therapy with pediatric work. In which case, I often hear people describe the idea that my profession gives me the skills to provide my daughter with above and beyond challenges that will give her an advantage in life.  

In some ways it does, but not how most would expect.  

Her Exceptional Fine Motor Skills

It was this Halloween a friend noted how well developed my daughters fine motor skills were for her age. My daughter can open jars, lids, and more things than I’d prefer. In fact, her well developed fine motor skills are slightly bothersome because we have to be so careful with what she can access. Halloween was not the first time others have made note of my daughters healthy development and made comments such as “I bet it’s great to have an occupational therapist as a dad.” However, being an occupational therapist has only helped me recognize the value of “day-to-day” activities. 

I mean, being an effective parent has as much to do with what I don’t do as what I do. 

A cute picture here
“The Itsy-Bitsy-Spider…”

The Gold Standard of Occupational Therapy

The gold standard of occupational therapy is “occupation.” That is to engage in the everyday tasks people do. This could include but is not limited to; showering, dressing, eating, playing, taking pets out for walks, going to the grocery store, and playing cards with friends. The mistake people often make about therapy when they imagine colorful cones, bins of odd shaped toys, and fancy gym equipment when doing those “therapy” like tasks, is that they are better than doing the everyday tasks I just listed. In truth, it is far better to be practicing showering, dressing, eating, playing, and so forth, than moving cones.  

In my opinion, the two things fancy therapy techniques and tools are used for is: 

  1. To support eventually practicing the occupation (showering, dressing, eating, playing etc.) 
  2. To avoid the miserable boredom of repeating the attempt at occupation if it’s not working. 

What I mean by number two is, if therapy is working on self-feeding, a patient can’t just practice eating for an hour or they would vomit. The use of therapy tools by occupational therapist is always only to support the eventual and hopefully current engagement in occupation or day-to-day tasks. That last sentence is not my opinion. 

Engaging in Everyday Tasks is the Best Therapy

It is not likely I could make my daughter a super human with therapy techniques. My daughter has well developed fine motor skills because I allowed her to help me hammer nails, wash dishes, prepare food, play with my special Star Wars Legos, and put many book shelves together. I was never providing therapy, but I was also not pushing her away from participating in every-day tasks. Kids are natural at engaging in occupation, the danger is when we stop them.  

Lots of Legos Here
Sharing the Lego Tradition

Even kids with developmental disabilities, the thing that is most beneficial, is for them to simply to be allowed to engage in day-to-day tasks even if specialized tools are needed.  

What parenting has taught me about my job as an occupational therapist, is the most effective therapy I can provide is often NOT me teaching and educating, but rather simply doing pumpkin carving. That is, simply to support and experience occupation with others. 

The day before Halloween I facilitated one of the best mental health groups yet. I measure this by my personal objective observation of joy and laughter. Group members said “I can’t believe I’m pumpkin carving in a locked inpatient unit” and “my girlfriend is going to be so surprised when I tell her what we did for group while I was here.” I even had one patient discharge and take her pumpkin home with her to show her kids. 

Pumpkin
Happy Halloween! I hope you enjoyed it and remained safe!

I don’t have lots of research for the post, just sharing a little something I’ve learned that I hope can be of value to you.

For more info on what Occupational Therapy is, click here.

For more about what I do, read: What I Teach for Mental Health

Coping Skills, Strategies, Methods, Resources, Techniques, or Tools?

Wish you could have seen this picture

The above video is a few of the coping tools I keep with me and use. As a mental health occupational therapist, I find it important to practice what I preach. I will go into the purpose and types of coping skills further in this blog post. 

The Need for Coping Skills 

There is an ever-greater need for mental health services for college students specifically (Watkins et al., 2012). Nearly 1 in 4 experience mental illness in college today (SAMHSA, 2017). Coping skills are in part, an answer to this situation. I explain in the video above, that coping skills are not simply for “dealing with mental illness”, rather they are what should be present in positive mental health.  

Unfortunately, effective strategies to cope with stress among college students today, may not only be lacking, but many of which may actually further contribute to the poor ability to deal with stress (Bland et al., 2012). 

What Coping Skills Are 

Coping Skills is a familiar term, for some it’s a word that means “run away”, yet others may actually want to learn coping skills. Whether the idea of coping skills needs to be rebranded or just approached differently is debatable. What is not debatable, is that we need to use them.  

There are a variety of ways to define and organize coping skills in medical literature (Carver & Conner-Smith, 2010). I believe coping tools are best described in simple terms as actions you can take to deal with negative situations. These actions could simply be in your head like practicing mindfulness or physical items such as writing in a notebook. 

Should have seen these books
My favorite tools come in the form of books

Types of Coping Skills 

Vivek Murphy, a former US Surgeon General, stated in an interview “The second thing we have to do is cultivate emotional well-being. There are tools, and they’re relatively simple. They include sleep, physical activity, contemplative practices like gratitude and meditation, and social connection as well” (“3 Questions”, 2017). Murphy’s list of tools is a great start. 

  • Sleep 
  • Physical Activity 
  • Gratitude 
  • Meditation 
  • Social Connection 

Feeling supported was the number one most positive factor students who deal well with stress report (Bland et al., 2012). The other factors found to be used by students who handle stress well include: 

  • Relaxed 
  • Extra-Curricular Activity 
  • Extra-Curricular Sport 
  • Exercise 
  • Listened to Music 

As an occupational therapist, I often use the senses (sight, smell, etc.) as an approach to coping tools. Mental illness can negatively impact how adults experience the senses (Bailliar & Whigham, 2017). A variety of tools can be used to use are sense to impact our emotions and experience. Examples include: 

  • Fidgets 
  • Stressballs 
  • Ear plugs 
  • Aromatherapy 
  • Weighted blankets 
  • Holding warm/cold items 

 Conclusion

I hope these few lists give a good start to coming up with ideas. Each of these topics could have additional lectures of their own, I’m sure you can easily find more information online. I believe there is great room to go into greater detail on types of coping skills. This article is a first step overview. I would be grateful to learn what coping skills you feel should be addressed, what works for you, and what you would do to make it more appealing? 

 For more information, checkout the article: What I Teach for Mental Health

 

References 

3 Questions. (2017, September). Official Journal of the National Geographic Society, 232(3).  

Bailliar, A. L., & Whigham, S. C. (2017). Centennial Topics – Linking neuroscience, function, and intervention: A scoping review of sensory processing and mental illness. American Journal of Occupational Therapy, 71(5), 7105100040. https://doi.org/10.5014/ajot.2017.024497 

Bland, H. W., Melton, B. F., Welle, P., & Bigham, L. (2012). Stress tolerance: New challenges for millennial college students. College Student Journal, 46(2), 362-376. 

Carver, C. S., Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology. 61: 679–704. PMID 19572784. doi:10.1146/annurev.psych.093008.100352

Farb, N. A., Anderson, A. K., & Segal, Z. V. (2012). The mindful brain and emotion regulation in mood disorders. The Canadian Journal of Psychiatry, 57(2), 70-77. 

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 

Watkins, D. C., Hunt, J. B., & Eisenberg, D. (2012). Increased demand for mental health services on college campuses: Perspectives from administrators.  Qualitative Social Work,  11(3), 319-337. 

Mindfulness: An Excuse to Eat Chocolate

A beautiful picture here

I frequently incorporate mindfulness in mental health practice. It’s something I’ve practiced long before I knew it had a name or a “scientific” action. I am quite an advocate of using mindfulness since it is essentially using our senses, which makes sense.  

Chocolate here
Mindful eating does not have to be done with a raisin

The Mindful Myth 

There is a negative opinion many have towards it, whether because pictures make it seem associated with either hippies or specific religious activities. Another reason is likely do to its association with the phrase “coping skills” of which many have come to grow tired of. People usually list deep breathing and music as their primary coping skills, when I ask. 

However, I believe the biggest problem is the approach to using it. In the video shared above, I discuss the value of mindfulness and the ways in which I make it less a chore and certainly more joyful an experience. I am a believe that we cannot feel joy 100% of our time, but I also understand that many have enough joy sucking life situations where they are only going to try a new habit if it might bring some type of relief immediately.  

A picture of my art
Origami is a great coping skill

Mindfulness & Flow 

I called the opposite of mindfulness, mindlessness. There in fact does exist another term called FLOW which is a better description of mindlessness (Csikszentmihalyi, 1991). The two mental states compliment each other and exist in opposite ends of your attention spectrum (Reid, 2011). Mindfulness is essentially your willful, intentional effort to be aware of your present experience through your senses. FLOW is a state in which you’re not trying to be intentionally engaged in something, you just are without trying, immersed in the action as some call “being in the zone.”  

Life is a roller coaster so the saying goes. Maybe we can’t change that, but zoning everything out to get to the end of the ride is a waste of a ticket. Both of these mental states, mindfulness and Flow, are to prevent you from feeling fully out control of your experience of everyday life (Bakker & Moulding, 2012). That is, you may not be able to stop a traffic jam on the way home from work, but there are ways to not be irritated by it for the rest of your night. 

A Mindfulness Book
Mindfulness and Mindlessness are my two favorite mental states

The Mental Health Benefits 

Mindfulness has been shown to support pain, depression symptoms, and quality of life (Hilton et al, 2017). I believe certain activities can be far more enjoyable to experience mindfulness with than others when first trying, if you’re the practical type. Engaging in hands-on activities are a good place to start, such as Legos (Barry & Meisiek, 2010; Csikszentmihalyi, 1996). As with any skill, mindfulness does not have to be a grueling hour practice every day, ten minutes daily works just fine for children and can for you too (Nadler et al., 2017). 

For types of mindfulness exercises, resources, ideas on how to make mindfulness more fun, and incorporate into your routine, watch the short video above. 

If you are curious about what other types of groups topics I practice for mental health, read the article found in the link below. 

What I Teach for Mental Health

 

Resources 

Bakker, K., & Moulding, R. (2012). Sensory-processing sensitivity, dispositional mindfulness and negative psychological symptoms. Personality and Individual Differences, 53(3), 341-346. 

Barry, D., & Meisiek, S. (2010). Seeing more and seeing differently: Sensemaking, mindfulness, and the workarts. Organization Studies, 31(11), 1505-1530. 

Csikszentmihalyi, M. (1991). Flow: The psychology of optimal experience. Harper Perennial: New York, NY 

Csikszentmihalyi, M. (1996). Creativity: Flow and the Psychology of Discovery and Invention. Harper Perennial: New York, NY 

Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … & Maglione, M. A. (2017). Mindfulness meditation for chronic pain: systematic review and meta-analysis. Annals of Behavioral Medicine51(2), 199-213. 

Nadler, R., Cordy, M., Stengel, J., Segal, Z. V., & Hayden, E. P. (2017). A brief mindfulness practice increases self-reported calmness in young children: A pilot study. Mindfulness, 1-8 

Reid, D. (2011). Mindfulness and flow in occupational engagement: Presence in doing. Canadian Journal of Occupational Therapy, 78(1), 50-56. 

How to Use Coffee for a Better Day 

A picture of a coffee cup

 How to Use Coffee for a Better Day

Coffee is one of the best known drinks in the US and world, I don’t have to argue that (Mitchell et al., 2014). I recognize, to many, coffee is not just some drink, it’s part of a valuable routine. If that routine works for you, don’t let me disturb that.  However, coffee can influence our daily energy and sleep, which in turn impacts our mental health. 

If your interested, I have a few tips to share. 

Coffee and Caffeine Content 

I didn’t know when I first started drinking coffee, that light roast has more caffeine than dark roast. Or that 2 shots of expresso is only equivalent to 1/3 a cup of coffee in caffeine content (Mayo Clinic Staff, 2017). This knowledge makes a big difference when studying for a test. Maybe your not studying for tests or pulling all nighters any more.  Instead, maybe it’s a better nights sleep you want.  

It’s suggested not to drink coffee past 3 pm, that’s because it can take up to 16 hours for body to get rid of the caffeine (Clark & Landolt, 2017).  

Coffee and Sleep 

So maybe you think, “I can drink a cup before bed and fall asleep just fine.” 

Actually, coffee can negatively affect deep sleep. 

This means you might not be awake, but your body isn’t getting the rest it needs. (Clark & Landolt, 2017). So you get up the next morning and drink coffee to wake up from the lack of sleep it may be causing.  

Another Problem  

One hour after waking is the normal bodies natural highest cortisol level (Krieger et al., 1971). This means the thing coffee does to make you feel awake, is already at peak performance. 

Adding coffee at this time makes your body less sensitive to it, building a tolerance. This tolerance is why people come to be able to drink more and more cups. The recommended maximum is only 4 cups or 400mg (Mayo Clinic Staff, 2017). 

Coffee a Better Way 

The better time for a cup is early afternoon, such as right after lunch when otherwise you might get a food hangover anyways. Late morning to early afternoon is when you have dip in your cortisol level and a cup of coffee then is perfect. Depending upon your tolerance, many argue a 2 week break from coffee is all that is needed to reset. I do practice this, and this works for me, it’s called caffeine cycling. 

It helps to avoid sugar in coffee, for that makes you crash harder and gives a false sense of energy. Also, coffee tends to make things worse for those struggling with anxiety (Clark & Landolt, 2017; Veleber & Templer, 1984).

Maybe you don’t drink coffee for the buzz, but rather for the joy of a morning brew,  and that is just wonderful.  I hope this may help you use coffee just a bit better to jumpstart your day and live mentally healthy.

 

References

Veleber, D. M., & Templer, D. I. (1984). Effects of caffeine on anxiety and     depression. Journal of Abnormal Psychology, 93(1), 120. 

Clark, I., & Landolt, H. P. (2017). Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials. Sleep medicine reviews, 31, 70-78. 

Mayo Clinic Staff. (March 08, 2017). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678 

Mitchell, D. C., Knight, C. A., Hockenberry, J., Teplansky, R., & Hartman, T. J. (2014). Beverage caffeine intakes in the US. Food and Chemical Toxicology63, 136-142. 

The Creative Value of Lego

A Picture of Lego

The Creative Value of Lego 

This is not a transcript of the video, though I have wanted to share my passion for Lego and video for a while. Finally, I did it. A special thanks goes out to the family that has been supporting my Lego addiction, and my wife for letting me keep them. I even offered to get rid of them after graduation, but my wife let me know she loved me anyways. 

When I was young, I was homeschooled. I did not enter the public education system until high school. Back then, I constantly complained about how I wanted to go to public school. While public school is not responsible for everyone’s problems, I can certainly say those homeschool years were possibly the best and most influential periods of time on my positive mental health. I believe boredom was one of the best gifts my parents ever gave to me; that was having me play outside and inside, with no cellphone, computer, or TV. 

How Lego Relate to Mental Health 

Millennials and particularly those age 18-25 have the highest rates of mental illness of any age, ever. This age group reports experiencing a mental illness in the past year at a rate of 22.1% during 2016 (SAMHSA, 2017).  Currently, college students are not only showing a poor ability to deal with stress, but in fact engaging in behaviors that are decreasing their ability to handle stress (Bland et al., 2012). Whether that is the helicopter parenting or the social media, is hard to determine, though Millennials are lacking strong skills in problem solving and patience, which are highly important to mental health (Howe & Strauss, 2000).  

That’s where Legos come in. 

The use of unstructured play time with Legos can be valuable early and later in life in developing problem-solving skills (Pike, 2002). Lego’s can stimulate convergent and divergent thinking depending on the format of play such as unstructured or completing a set following instructions (Mochari, 2015). Lego’s and similar “artifacts” (toys) even show potential to provide creative inspiration and foster mindfulness, bringing greater meaning to the work experiencing (Barry & Meisiek, 2010). What’s there not to like? 

Is Lego the Solution? 

Will playing with Legos fix all our mental health problems? 

It’s unlikely. 

That’s not my point either. Rather, recognizing the value of learning how to problem solve and deal with boredom at an early age has significant benefits later on in life. For parents that means less screen time for their children, and for themselves too (Sudan et al., 2016). While Legos may not be the answer, its likely exercise, community engagement, and productive use of leisure time would support better mental health, whereas passive activities, such as smart phone use in particular, do not (Barkley & Lepp, 2016).  

What’s important to recognize, it’s never too late to begin developing better mental health. So my call to action is to grab those crayons, Legos, note pads, journals, camera, paper, and put away your cell phone, computer, laptop, and ipad. I mean keep those devices out of reach and far away, because your hand will itch to pick them up. If your feeling writers block, or creative block, it helps to have some inspiration. But this can be done with magazines and not Pinterest or instagram. That is a topic for another day. Today, maybe that will be an excuse to go to the library and find a few books on photography or knitting, or drafting, and maybe, just maybe… 

…Lego. 

Expect to see more videos coming soon! Until then, you read my first post here: The Best Job Ever: Occupational Therapy in Mental Health

 References 

Barkley, J. E., & Lepp, A. (2016). Mobile phone use among college students is a sedentary leisure behavior which may interfere with exercise. Computers in Human Behavior, 56, 29-33. 

Barry, D., & Meisiek, S. (2010). Seeing more and seeing differently: Sensemaking, mindfulness, and the workarts. Organization Studies, 31(11), 1505-1530. 

Bland, H. W., Melton, B. F., Welle, P., & Bigham, L. (2012). Stress tolerance: New challenges for millennial college students. College Student Journal, 46(2), 362-376. 

Howe, N., & Strauess, W. (2000). Millennials rising: The next great generation. New York: Vintage Books 

Mochari, I (2017, Aug 20) How playing with legos (the right way) boosts your creativity. [Blog post]. Retrieved from https://www.inc.com/ilan-mochari/lego-creativity.html 

Pike, C. (2002). Exploring the conceptual space of LEGO: Teaching and learning the psychology of creativity. Psychology Learning & Teaching, 2(2), 87-94. 

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 

Sudan, M., Olsen, J., Arah, O. A., Obel, C., & Kheifets, L. (2016). Prospective cohort analysis of cellphone use and emotional and behavioural difficulties in children. J Epidemiol Community Health, 70(12), 1207-1213. 

 

What I Teach for Mental Health

What is Mental Health OT? 

People often confuse occupation for vocation, meaning therapy strictly relating to employment or job status. However, occupational therapy (OT) actually began with mental health in mind.  

The civil war sparked the thinking that led those observing bed-ridden soldiers during WWI to believe the soldiers were suffering more from mental debilitation than physical debilitation. Long story short, 6 figures initiated the official practice they called occupational therapy. This is because as humans we must ‘occupy’ our time with goal-directed, meaningful tasks that make up our daily routine. The WWI vets often suffered from PTSD and depression, OTs helped them engage in craft and trade skills such as leather work and pottery. Sometimes, this meant they had to create a prosthesis for missing limbss, or teach skills in groups.  

Today, creating a prosthesis and leading groups is only a small sample of the variety of OT roles, however, now those roles tend to be separate and more specialized. This is why you may see an OT working with kids in schools, adults in nursing homes and rehabs, or mental health facilities like myself. My primary role, as an OT in mental health, involves more group leading.

Want to know what I believe is the hardest part of working with groups in mental health? 

Emotional intelligence. 

It’s like the challenge of public speaking plus the fact most people don’t want to be there. If you were dealing with an incredibly difficult time in your life, would you want to hang out with me?

Well maybe you would, or at least tell me that, but often that is not the case for people in the hospital.  It’s important as a mental health worker to be able to recognize my own emotions and manage myself tactfully in order to be effective at working with others having a difficult time with their mental health. It takes a delicate approach and equally important, practicing what I teach.  

What Topics Do I Teach? 

The primary categories my groups go into, include;  

It’s not simply the topics that define occupational therapy groups, it’s the way its taught. Again, occupational therapy is how we ‘occupy’ our time with meaningful and purposeful activity which makes up our routine. My job is to help create a healthy routine through meaningful tasks or activities. The challenge is people suffering from whatever is happening in their life, that led to visiting a mental health unit, often clouds their vision of recognizing anything as meaningful. What can be considered meaningful is also broad and abstract.  

How I Make Groups Meaningful

In some ways, it can be a shot in the dark to figure out what is meaningful for the people I work with. We have assessments, but not everyone is interested in answering questions or having a discussion. The same group done the same way can one day be loved and another day be hated. I was asked a difficult question about group topics once. The question was: 

Do you think some groups are more occupational than others?  

I have thougt a lot about that question. The short answer is no. This is because what is meaningful at 10am versus 2pm versus 4pm can be different and change from day to day or even hour to hour. 

Want to know something that might surprise you?  

Sometimes occupational therapy group can be playing Wii tennis. It can be often that Wii is the only alternative. I frequently change the plan immediately before starting a group if need be, or take multiple plans with me and decide what we’re going to do depending upon who shows up. 

Would you want to exercise right after lunch or listen to a lecture at the end of the day?  

How I Make Groups Interesting 

One of my biggest roles is adapting the right task for the right time and person. Adapting often means, making things interesting such as mindfulness. Mindful eating has been historically taught with raisins. Can someone say BORING! I use Lindt chocolates for this reason!  

It’s like any sales job to excite people about positive health changes. One of the biggest lessons I’ve learned with mental health treatment techniques is, before they can be effectively taught, you have to believe in them yourself. First, I successfully implemented them in my life, then I learned how to teach them in a fun way.  

Conclusion 

I said in my last post I was going to share what groups I lead, so I hope this peeks your interest in mental health topics. Want to know more about those topics? 

Are you interested in how you can make effective goals and actually implement them now so you don’t have to come to my groups later? 

Next I’m going to share about those specific group topics in individual posts.

If you missed my last post, click the link below!

The Best Job Ever – Occupational Therapy in Mental Health

If your a therapist interested in some ideas on how to make your therapy more engaging: START HERE.

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

 

You can expect Bi-weekly blog posts. For more updates, checkout my social media channels found in the links below.