Enabling occupational engagement in the transition to independent living using a longitudinal case study approach
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Individuals with serious mental illness (SMI) highlight their preference to live independently in their own normal housing in the community as opposed to congregated settings consistently. Research has shown they experience impaired occupational and social engagement and thus require individualised support to enable occupational engagement in the context of transitioning from community residential facility to independent living. This longitudinal case study research evaluated the impact of individualised occupational therapy interventions to enable occupational engagement in the context of the transition from community residential facility to independent living. Two individuals diagnosed with schizophrenia were provided with individualised interventions by Occupational Therapy Assistants (OTAs) to enable occupational engagement over a two-year period. The intervention was withdrawn on a phased basis. Mixed methods, including qualitative interviews, quantitative measures and cost evaluation were completed at baseline, during the intervention, post-intervention and one-year post intervention. Two themes were identified: the first related to how the participants learned to live independently in the community and the second to how the service providers and participants negotiated the right levels of support. Standardised assessments identified attainment of personal goals, improvements in perceived competence and satisfaction in occupational engagement, cognitive skills for independent living, mental health recovery and quality of life. Improvements were maintained one-year post intervention. Significant reductions were identified in the overall use and cost of health service provision. This study provides initial evidence for the value of intensive, individualised occupational therapy to facilitate transition to independent living and enable longer-term engagement in valued occupations and roles in the community.
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