Occupational Therapists (OTs) are one of the great unsung heroes of the medical system. They play a key role in the rehabilitation and recovery of patients suffering from a variety of long term conditions. Unfortunately, they rarely get any credit for this, mainly because only people who have availed of their services or who work for the NHS actually know they exist. Everyone else thinks an OT is some sort of physio, or, alternatively, the person who sorts out a suitable chair and mouse mat for you at work. Here, I’m going to explain, using examples from my own experiences as a mental health patient, what it is that OTs actually do and why I think they are just fantastic.
An Occupational Therapist works as part of a multi-disciplinary medical team, usually based from a clinic or hospital, with patients who have been diagnosed with a condition that requires an extended period of management or care. The purpose of Occupational Therapy (OT) is to help patients organise their time and energy in a manner that is optimal for getting better and improving their quality of life. This can cover everything from coming up with a personalised timed activity plan with someone who has CFS/ME to holding art classes in inpatient units for stroke rehab patients. The stereotypical depiction is of the hippie earth mother type who exhorts the patients to “feel the spirit of the earth” during basket-weaving classes, but this image is about as accurate and up to date as Kenneth Williams’s doctor in “Carry On Matron”. (Although Williams’s performance is still pretty damn entertaining).
The central tenet of the OT approach to mental health recovery is that you, the patient, need to keep yourself occupied as much as possible. Routine and structure, with a healthy dollop of socialising and creative, relaxing activities that you enjoy and do not stress you out, have been shown to be strongly correlated with improved outcomes after treatment and discharge from hospital. Sitting on your arse doing nothing all day is bad for your mental health, full stop, however crappy you may feel. So is doing too much, too soon, getting tired, stressed and worn out.
I want to stress here that OTs, in general, don’t generally think that their approach is all you need to get well and stay well – their contribution is intended to be an addition to, not instead of, medical treatment from a psychiatrist and regular visits from your CPN. You will find the odd one who refers to doctors behind their back as “drug dealers” and think everyone should just pull their socks up and attend art class and everything will be fine, but these are exceptions.
The most common manner in which a mental health patient will come into contact with an OT is during a stay in hospital. Many psychiatric hospitals have an OT department that organises activities during the day. Some hospitals have no money and organise precisely nothing at all, but this is unusual in the UK.
There will generally be a timetable on the noticeboard, letting you know when pottery, art, gardening and guided relaxation sessions are being held. You just tell the nursing staff which classes you want to attend and they will come round to remind you beforehand to make sure you show up. Hospital activities are heavily loaded towards the arts and crafts, because these are things that you don’t necessarily need a high level of concentration to engage in and most people, regardless of age or social circumstances, enjoy doing them.
I’d recommend, if you do find yourself in hospital, that you attend as many of these activities as you possibly can, with the exception of anything you actively dislike (for example, I loathe pottery). The reason for this is, although you may not be the world’s keenest gardener, attending the class is better for you and less boring than sitting on the ward watching Jeremy Kyle. Again.
When I was a patient in Big Dublin Hospital, the OT activities were pretty unstructured – you just showed up and did whatever you wanted really. There was some inter-patient chit-chat, with the OT making sure everyone had enough materials and no-one was about to freak out. You could leave whenever you wanted to. The art room was open all day and you could drop in as you felt like it. The exception was when I was on the Young Adult Program, where all activities were timed and compulsory. Did I mention that I hate pottery?
At the Royal Edinburgh, all classes were carefully structured and lasted an hour. You could leave if you started to have problems, but there was no readmittance. One OT led the class, with a second participating, just like the patients, sometimes also with a student on placement. All of them would carefully engage each patient in conversation in turn, deflecting the topic from any mention of doctors or medication and doing their best to give the patient the impression they were relating to them as a regular person and not some sort of diseased leprechaun. There was always a tea break in the middle with some more carefully honed conversation. While the work was on-going, the OTs would go round making a big deal of praising everyone lavishly for what they were doing.
To be honest, I could have done with a bit less of this. it was too obvious to me what they were doing and it just served to remind me, once again, that although I might direct complex projects at work and have a full social life, right now all I was good for was painting a Saltire on to a bathroom tile and discussing my home town with a hospital employee who was paid to talk to me. Still, it was definitely better for me to slop paint about than watch Cash In The Attic. Plus the approach worked a treat on most people. I guess I’ve just been in hospital too many times.
The reason classes like this are put on is twofold. Firstly, it’s something to get you active and doing stuff instead of hanging around the ward, and we know activity is good for you. Secondly, it’s to introduce people who might never have thought of taking up, say, flower arranging or woodwork, to new hobbies, that they then continue doing once discharged and so have a mentally healthier lifestyle.
What I learned from participating in the available activities in both hospitals was that the OTs were right – I did need structure and I did need things to do that didn’t stress me out. I also needed to know my limits and how much activity was too much – I tended to go to too many groups rather than too few. Once I was able to recall the positive benefits of being active, getting out of bed and doing stuff became a lot easier. I was also able to continue carefully structuring my time when I was discharged, so as to support my recovery.
In addition, whenever I started to get ill again and was off work for that reason, I knew I had to find suitable pursuits to keep me busy during the day. I don’t know how I would have gotten through the latter half of 2009 without a strict timetable of activities for which I had to get out of bed at a decent hour.
The other way in which OTs help patients is in working with you individually. When I was admitted to the Royal Ed in 2008 the OT student had a long chat with me about my lifestyle, habits and hobbies. She drew up a timetable for a normal week for me, and pointed out that I was getting insufficient sleep. On top of that, I wasn’t doing anything much to relax, ever – I was on the go all the time. She asked me if I always pushed myself hard in the gym or just relaxed and enjoyed the workout (I think you know the answer to that one).
She got me to draw up an alternative weekly timetable, which had time for relaxation, fun and just having a good time built into it. We also talked about how I approached things like work, the gym and my weekly commute. She highlighted a number of small but significant ways I could reduce the stress I put myself under without this being detrimental to my life or career. Then, she got me to promise to stick to it when I was discharged! Of course I didn’t then. I am now though!
Similarly, when I was first assigned a CPN last September, an OT came along too, to see if I needed help coming up with activities and things to do during the day. I discussed my pretty comprehensive weekly activity plan with her and she agreed I didn’t need her services – however, these are available to patients who need them.
This may all sound blindingly obvious to you, but remember, the reason you know this is probably because your own experience has taught you that you MUST keep busy during times of illness or unemployment in order to not feel even worse. Many, many people who wind up in hospital do so because their mental illness is aggravated by poor coping mechanisms, or because they have additional stresses in their lives, like sole care of young children or working long hours on a low income, that make taking time out to relax very difficult for them. For example, I tended to use my weekly commute to London as an excuse to just keep going and put myself under more and more stress, because I felt guilty whenever I allowed myself to relax. I needed to be taught how to occupy myself without putting myself under heinous pressure – without this, I’d just have had breakdown after breakdown.
In particular it was hard for me to learn that I didn’t have to achieve all the time – so what if my Saltire painting was easy to do or the arms were a bit wobbly – what mattered was enjoying the time I spent doing it and having a natter with the others.
Therefore I think the efforts of OTs on my behalf, in Dublin and Edinburgh, have quite significantly contributed to the level of recovery that I enjoy today. So next time someone tells you they are an OT, don’t look puzzled, congratulate them on the vital work they do instead.
Footnote: You’ll notice I hide the name of the Big Dublin Hospital yet am happy to name the Royal Ed. This is because I’ve had a lot of unflattering things to say about the former, but the latter were great – I don’t think anyone at the Royal Ed will mind my singing their praises.
Great overview, DeeDee. I’d always wondered exactly what OTs did in relation to mental illness, so this is quite enlightening. My psychologist is trying to juggle more balls than he should. He has the actual therapy to contend with, plus he is trying to get me to develop some structure in my life and he tries to discuss practical anti-mental measures. It’s too much for one person, in my view, and to that end I’d really love to see an OT. I know there are a few attached to CMHTs, but nobody seems to want to refer me to anyone else. *sigh*
Anyway, they clearly do very worthwhile work. Thanks for drawing our attention to it
Very interesting.
The other role the OTs perform (usually as part of CMHTs) is to assess with people need help with Activities of Daily Living ie. can you cook, can you wash your clothes, can you keep your house clean? Then working with individuals e.g. by getting adaptive technology in (especially in older age), encouraging them to keep trying, or by hooking them up with a cooking class…
Our OT was always fond of the cooking assessments. She’d accompany the client to the supermarket, then the CMHT’s kitchen to assess their ability to buy ingredients and cook a meal, she then got to share the meal with the client (this could be anything from an exquisitely prepared cordon-blue 3-course mean thing, to undercooked beans on burnt toast), whilst smiling and saying how delicious it was…
Cool, I didn’t know this. That’s pretty good. Probably also another reason that the OT came with the CPN on the first visit, in case I needed to get help of that kind?
This was interesting. I used to have an OT as my care coordinator, and I liked her, but she just came to my house and sat and chatted with me really, much as a CPN would. My current CMHT also has an OT, but again, she just has a caseload of people that she care coordinates.
The Royal Edinburgh sounds very impressive. There was very little in the way of OT in either of the NHS wards I have been on, and my local ward is apparently the same. The art room was opened for a couple of hours a day, and you could go in there and do whatever you wanted in that time, but it was certainly nothing like the OT you had at the Royal Edinburgh. There was no structure to it at all, and some days even the couple of hours wouldn’t happen, as it all depended on staffing levels. I think that OT in psychiatric hospitals is very important, and really needs to be allocated more money, so that some minimum standards can be met nationally.
The Royal Ed also benefits from the fact that it shares the OT facilities with a big day hospital for people with learning difficulties, so there are loads of facilities.
Woodwork was my favourite.
Interesting post DeeDee. My own experiences with OT haven’t been too good, since most activities are not accessible to me cause I am also blind or they could be accessible but I require too much assistance. For thisr eason I can’t attend as many activities as I’d like. I for one have had the best experience with movement therapy / activities (don’t know if that exists in the UK and if so what it’s called). These are not the same as OT though.
I never got much help from them but then they probably hate me.
can you take that the last ot wasn’t excellent she put me in touch with creative writing people who said that my future was bright hahahahahahaha
can you take that the last ot WAS excellent she put me in touch with creative writing people who said that my future was bright hahahahahahaha
I think OT have a very strong position in assisting in ADLs and restoration of functional level. This means they can work in pragmatic approaches that helpfully complement the medical, nursing and psychological approaches of colleagues. What goes pear shaped is when, like any professional, they get a bit eccentric/peculiar/weird. I’m still waiting for someone clever to do a Slapheads : Occupational Therapists post.
C’mon, we must have met some, no?
Purist Polly who thinks any doctor or nurse is oppressive and forcing a construct of medical paradigms on what’s just understandable behaviours arising from distressing experiences, so just needs attention to managing function instead of all that diagnostic and supportive and interventional nonsense CPNs and folk do. She tutts and hisses when doctors or nurses are mentioned, is bitter that there are more doctors and nurses in the NHS than OTs and constantly has to paint OT as the best thing ever since oxygen whilst putting down “orthodox outdated working models,” like doctors and nurses seeing patients instead of OTs.
Basket-weaving Brenda who think the solution to any problem is to occupy oneself. Busy hands make for a busy mind. Can’t be out of sorts then, can we? So let’s all weave some more baskets.
Hippie Hugh who reckons the best way to solve distress is to sit down in a circle (ideally in the wondrous bounty of Nature’s bossom, but a carpet will do, at a push) and reflect ‘pon how we’re all inherently part of nature, which is a well oiled machine withe everything in balance and harmony, so for us to be part of this and ticking along we just need to re-connect with our place in that. Hug a tree, meditate and you’ll be cured in no time.
Psycho Saul who thinks peoples’ function is about being part of the shared consciousness, man. A bit like Hippie Hugh, he thinks that you just need to stop focussing on details and worries and specific issues and instead let your mind go an’ be a part of the Big Picture. This is achieved through pop psychology, his own bias and the 3 day course on some CBT modules that seemed interesting to him in 1998. This empowers him to now dabble is psychological interventions, rummaging around in peoples heads, to help them be at one with the cosmic consciousness. Because only then will peace and tranquility be theirs.
Someone do this properly and generate a Slapheads, pretty please?
Ah, there was a Purist Polly at Big Dublin Hospital. I didn’t have many dealings with her though. Some people were referred to her in her other hat for counselling though. That was not pretty.
The closest to a hippie hugh I’ve met was a student on placement. She was pretty practical though as well and I think just a little naive, having previously worked with developmentally challenged adults. She nearly fell off her chair when I shouted at the SHO during the ward round (in my defence, I was in a manic/mixed state). She was also really upset when a very manic patient was rude to her. I think she got over all that pretty fast though and will make a great OT.
You just did a post, Dr Shrink, why didn’t you post it? (So to speak.) Hugging trees can help, it’s not mutually exclusive. What’s Nature’s bossom {sic}? Is it pear-shaped? Oh, Hugh’s a bit of a Kleinian, it’s bosom you’re after. Enjoy!
I find OTs useful in providing bits’n'pieces round the home – a kitchen stool here, a bathroom thingummy to stop you levering yourself up from the bog by using the sink there. They become very nervous if asked to help put pressure on the City Council, negotiation is clearly not their thing. Frequently heard phrase on the lips of RGNs when I was in General Hospital: “Bloody OTs!”
Dee Dee thank you very much for another very enlightning piece. My own interest in OT workers is that they are regulated by the HPC (Health Professions Council) and as many of you are aware I am pro HPC regulation for psychotherapists.
Does anyone have any experience of an OT being in anyway restricted by their HPC regulation? For example have they ever been restricted in how they speak to clients, how they conduct their day to day interactions with clients etc? Is there any sense that the HPC is in anyway sitting on their shoulder stopping them doing their jobs?
Not that I’ve noticed from my OT colleagues.
With regard to the HPC/psychotherapy debate, it’s also relevant to mention that OTs use a model of working that is radically different to the medical model, and the HPC have not stopped them from doing this.
Thanks for this post, Dee Dee. It’s great to hear how different OT is now from my experiences of it over thirty years ago. I was given no choice but to go do OT and this often consisted of unimaginative activities such as knitting dishcloths and making ashtrays. Fine, for anyone who liked doing that kind of thing. I was bored out of my brains, drowsy with drugs, and my time at the OT department was like a test of survival. I was once asked to paint a duck in a child’s colouring book! On another occasion I was given a crayon and a piece of paper. I wasn’t interested in what I was drawing on it and I’m sure a child in primary class could have done better, but I had to put up with: ‘My, isn’t that good! Look at this! Isn’t she clever?’ from a group of visiting students. I could say a lot more about the horrors of OT but I won’t. After all, my experiences were a long time ago. It’s good for me to be reminded that some things have changed for the better. And very much so, it seems.
I made an ashtray in pottery at Big Dublin Hospital while I was on the young adult program, as everything on that program was compulsory. I hate pottery. btw, I don’t smoke. The ashtray currently holds a collection of euro 1c and 2c coins.
My ashtray was made by pulling small coloured tiles (sticky underneath) from some gauzy backing material, and sticking them onto an ashtray-shaped ready-made metal base. I don’t smoke either. I don’t remember what became of the thing. I do remember that, shortly after my discharge, a pastor visited me at home, looked at my ashtray and exclaimed that it was like what children in kindergarten make. Yep, too true.
I’m now imagining a class of kindergartners making ashtrays. Can’t imagine the parents being too keen on that one!
Ah, I have an ashtray too! painted yellow, with a smiley face in the middle
Our OT’s were lovely, though. The students especially – I always had someone to play cards or scrabble with when they were around!
This thread is just reminding me of Tim Minchin’s ‘Angry (Feet)’ – “At school I had trouble making ASHTRAYS!… friends”
I have found this thread fascinating and a genuine insight into the work of OTs – who, Dee Dee was coreect, I had previously thought had something to do with RSI in the workplace or something. I didn’t realise how interconnected they were with the habilitation processes – sorry I don’t know the technical or politically correct terms.
One thing has struck me though from reading this, and I will stand corrected, but are the activities – pottery, basket making, painting etc a little twee and maybe patronising? As you have pointed out do they have any relevance to how anyone actaully leads their lives – making ashtrays? Could anyone suggest any same skills level but more relevent activities? My first thoughts went to cookery and maybe even something more engaging like basic photo shop or even internet information gathering.
Of course please bear in mind that I have absolutely no idea what I am talking about on this subject.
My local CMHT does a cookery class as part of OT.
I think the reason a lot of the inpatient stuff is heavily arts and crafts based is because you have so little concentration ability as a patient. There’s no way I could have used a computer when I was in hospital, because I couldn’t read a sentence and remember it. I think pretty much everyone else was in the same boat – severe acute mental illness really screws with your short-term memory. So the range of activities you can do is pretty small.
Plus they have to be things almost anyone can do without prior training, which rules out rock-climbing.
For people as outpatients, there is a wider variety of groups (gym visits, cooking, etc) and there is all the 1-to-1 help as well, with finding stuff to do and with general life skills (mkaing your dinner, doing your laundry as well). Big Dublin Hospital also had a “computer” room for people who were well enough with software to teach yourself to touch-type.
Occupational Health deal with workplace safety and health, and are often medical Doctors and mainstream trained nurses, often supported by physios, radiographers and other AHP’s in the larger OH centres. OT’s can be involved in Occupational Health, but we don’t have to be.
“One thing has struck me though from reading this, and I will stand corrected, but are the activities – pottery, basket making, painting etc a little twee and maybe patronising?”
Some people will be patronised by the activities – I once worked on a ward that ‘housed’ a university Professor for a few weeks, pretty much every activity was well outside his intellect and area of interest. Others will “Never have realised I could do anything like this”.
Depending on where you are OT’s can also cover sports a few times a week, cooking sessions, money management, relaxation, yoga, creative writing and a few other things.
As DeeDee correctly points out, some MH patients really lack their usual capacities when they are severely ill. Add in the sudden explosion in ‘free’ time and you suddenly need a lot more activities of a simpler nature just to avoid decline of your basic day-to-day coping and living skills.
“As you have pointed out do they have any relevance to how anyone actaully leads their lives – making ashtrays?”
The ashtray is just the product. The process – engaging proceedural memory, working memory, short term memory, sequencing, object recognition, attaining, maintaining, switching and encoding concentration, formation of new memories, recall and a whole slew of other neurocognitive and psychosocial skills – is what the OT is using to produce the therapuetic effect (ideally, not all OT is going to suit all OT clients).
The distinction between “OT’s use activity for effect” and “OT’s use activity” is one that even other professionals have difficulty with. Oddly, nurses are both the professionals least likely to understand OT and the most likely to see the point of it. Sometimes the same nurse will both ‘get the point’ of some activities but not ‘get’ others.
Sometimes MH clients struggle to cope with more than a few steps of an activity, or more than a few bits of information at a time, which is one reason OT’s choose gradeable activities.
Also, just because someone is a university professor doesn’t mean they won’t like flower-arranging.
I found it useful to get down off my “this activity is beneath me because I am Ms high powered IT geek woman” high horse and just have fun without needing to be fantastic at whatever I was doing. After all, watching Jeremy Kyle wasn’t beneath me, so why would OT be…
“Also, just because someone is a university professor doesn’t mean they won’t like flower-arranging”
Indeed, and someone who worked/works in a florist might not want to be anywhere near the session. Thankfully, he would get out of bed for something like backgammon as long as his opponent was fairly decent and could talk about the main issues in the politics page of the paper. Otherwise there simply wasn’t anyone else on the ward that could hold their own in conversation with him at his level and in his areas of interest. Not to say everyone else was stupid (they weren’t) but some held reduced capacities for conversation with anyone, and – most importantly – most held different interests.
The key thing that is centre of most, if not all, OT models is that each person has a thier own set of things that interest and motivate them. Many OT activities are chosen for their wide appeal, cultural relevance, gradeability and so on, and are set up so that the setting itself can be used for therapuetic effect.
As an example, a pottery session, at one and the same time, has the potential to be used to ‘train’ sequencing and memory etc, provide a positive motivational experience, and act as an semi-protected controllable environment for coping with other people, with conversation, with critique, with interaction and so on.
And it can give you something (hopefully) positive and common to talk about back on the ward and even with other present and former clients at a later date. Exactly as is happening now in fact.
I understand the point of these processes but I can think of very few people who would be happy with being asked to produce “just the product”. Making something somebody can relate to is fundamental. Otherwise we’re back to making baskets, pulling them apart and remaking them.
Indeed, this is why you’re supposed to select an activity that has meaning to the person, rather than just any activity.
Unfortunetly, although occupation for the sake of occupation is heavily disdained in the academic field, when it comes to actual practice, limitations on time, skill, staff, resources, finance and space will mean you can only offer a limited range of activities.
Add in the headache that is the “OT’s use activities, therefore activities are OT” mindest (that is used to pass off responsibilities for funding and staffing ward activities to the OT department) and resources rapidly dwindle whilst pressure to provide non-OT services as OT escalates.
If you end up in a place where OT is purchased by the wards, rather than provided for by a central fund, you could end up having OT that is timetabled and dictated according to the needs of the service, rather than the clients.
Unfortunetly, there are far too many services that do things “because it’s thursday, and thats what we do on thursday”.
I agree with all that. Various activities are the responsibility of various people. Managers please take note! I have a friend who has set up work retention projects for stressed employees of local councils, etc. A former MH professional/CBT therapist, he has consistently refused to use RMNs (I think his reasoning is out of date), only OTs.
The local trust has asked me if I want to “help with art therapy” pro bono. I suppose that’s one way of taking care of the funding. BTW this is cheeky perhaps and I do realise I’m on thin ice but have you had a dyslexia test (speaking as one with a wife and son who are dyslexic)? You have a consistent pattern of mispelling certain words that makes me think it’s something you might find it worth checking out – and leaning on occupational health to pay for. I really do hope I haven’t embarrassed you and apologise if I have.
No dyslexia test although I did sit a screening test before college that didn’t show anything. I do have a neurological condition that is often accompanied by sub-clinical dyslexic traits or dyslexia.
I do have difficulty with transposing c’s and s’s if they’re phonetically similar (like neccisary/nessicary) as well as ou, eau/au, ie, and cei/cie, and so on. Both myself and my mother have the habit of using words that can have similar meanings in contexts where they do not share the same meaning.
Curiously, a significant proportion of my cohort either had dyslexia diagnosed at school, or only had it diagnosed once in Uni. This was especially true amongst the mature students. I think the rate was close to 17-20 out of 95.
Getting that diagnosis helped clear up a lot of things for a lot of people. It allowed many to see that they weren’t as thick as they’d been told.
That’s very interesting. There was a time when it was practically universally believed in the education system that there was no such thing as dyslexia, some snide teachers called it “pushy parent syndrome”, or that as long as someone learned to cope (in a culture of low expectations) there was no problem. That would account for the older members of your cohort particularly not having been picked up.
My son wasn’t picked up until uni and neither was my wife. In Young Sir’s case that was partly my fault. I’d been used to him in his teens accusing me of being a bad parent because I hadn’t had him put on ritalin like his chums (no particular reason why I should have done, he just felt left out!), etc., putting it down to the Winnicott idea of being a ‘bad enough’ parent, who gives teenagers space in which to rebel, as well as the more generally known ‘good enough’ parent. So when he told me at 15 he thought he was dyslexic I didn’t take a lot of notice. I was wrong. Still, he’s a TV producer now, which I don’t think would have happened had the uni not been on the ball.
Did you notice I misspelt ‘misspelling’ as ‘mispelling’? Hrumph! Enough said.
Don’t be too hard on yourself Michael. Parents are not doctors, psychologists, endocrinologists or clairvoyants. How would you spot it unless you had training to do so?
Thanks, DeeDee! He certainly loves his dear old Dad now.
Just had another pointless brainwave – flat pack furniture building – IKEA et al provide the old stock / seconds etc – the OTs work with people to build them and then they can either be given to housing charities or you can take them home for your own use – probably after taking them to bits again – imagine the hours of fun to be had chasing the missing parts.
ARRRGGGGHHHHHHHHHHHHHH. (reaction to being asking to put together IKEA stuff). It would certainly teach you patience. The ARGOS stuff is even worse, at least IKEA generally have all the parts you need when you guy it and you’re not missing that crucial screw or allen key.
Ah, that’s industrial therapy you’re talking about, which started in the late 50s/early 60s at two hospitals in particular, Netherne (Surrey) and Glenside (Bristol), both of which rated a mention in Reader’s Digest of all places. I’ve worked at both, both are now closed, but not because I used to work there. It was originally conceived as something to give the lads and lasses on the locked wards (now PICUs) something to do and a means of earning cash.
There was a theory that schizophrenics could only cope with simple, repetitive work and so the original contracts were for assembling ball-point pens and TV aerials. At Glenside, this expanded into the Industrial Therapy Organisation, a workers’ co-operative with hospital admin support, in an old factory on an industrial estate, carrying out all manner of work, initially in the teeth of vehement trade union opposition (the same regional office of the same union that in the 50s opposed black bus drivers working with white conductresses, especially after dark), the workers mostly living in the community or on open wards. It closed after the Disability Discrimination Act began to take effect.
I have no recollection that Netherne OTs played much part in Industrial Therapy. OT schools at that time had a ‘finishing schools for nice young ladies’ atmosphere. At Glenside they certainly did not because although there were OT departments in the two Bristol psychiatric hospitals they were run by nurses: there were no OTs as such.
My ikea lamp melted. Probably my punishment for stealing all their pencils! I think if assembling furniture was included in OT, I’d end up throwing a flat pack table at someone or something.
The ward I was on last year had a great variety of OT activities – pottery, art, creativity, cooking, music, games, fitness, yoga and if you were ‘well enough’ a weekly social activity like a trip to a coffee shop or something. I was very impressed with how it was all run really.
Flat pack furniture building? Ah, yes, now that would have kept us quiet.
I remember occasionally at the OT dept we were given some unpaid work to do which they called ‘industrial therapy’. We packed greetings tags for a local firm – counting out the tags and putting them into small polythene bags. The memory comes back now whenever I see a greetings tag that says ‘Merry Christmas’ next to a smiley Santa. Eeeek!!! Christmas. Bah, Humbug!
I can believe this but as described it was a travesty of what we pioneers did at Netherne and Glenside.
You could have had Laurel & Hardy style fun with flat packs, though. Five points for reducing an OT to tears; ten for a customer.
This reminds me of how (at High Royds in Yorkshire, back in the early-seventies) a student nurse organised some therapy for us that was fun. He took us into the grounds and lined bottles up on a wall, got us patients to form a queue and gave each of us a stone. We took turns in seeing who could smash the most bottles with the least throws (bottles were glass in those days). The patient who usually won was a man who pretended the bottle he was aiming at was his psychiatrist who, for some reason, he wasn’t too happy with.
You’re right again DeeDee IKEA have got so much better than they used to be.
My brother is an IKEA fanatic and travels the country going to every store. He’s managed to build entire sets of fitted wardrobes out of the bargain area and the free spares department. Recently discovered that the same high gloss grotty green wardrobe doors varied in price from £129 per pair in Sheffield to £35 per pair in Cardiff because every body had more taste in South wales and didnt want them.
What’s this got to do with anything? Oh yes skills levels – so is there any activity that might be more appropriate, satisfactory and of life skill value? I made a coathook in metal work at school and it’s still on the back of my mum’s pantry door. How proud I am of the longevity of my craftsmanship.
My wife made some really good sculptures last autumn. I can think of artists (professional and amateur) who started with the help of an imaginative OT or nurse.
I’m not THAT much of an IKEA fan. It’s ok as cheap furniture goes, but you can get lovely solid stuff from the small ads for the same cost. You go round for a week putting down deposits on the things you want, then you get a Polish guy with a ford transit to go round with you and collect it all.
I got a fabulous chaise longue from a woman in Hitchin on ebay for 120 quid…
I think I want the UK sort of OT. In the states what I have mostly gotten is “we will insult your intelligence by making you do a crossword puzzle with three other patients in a group” or “we are going to play bingo, but because you are the only person in the room who can see or hear anymore, you are going to have to play everyone’s bingo cards for them.” That bit about looking at one’s current schedule and changing it around a bit to be more conducive to mental health, that bit sounds wonderful. And ADLs, I loathe them so much right now. They take up so much time! With the chewing and the showering and the toothbrushing, I feel like I spend all day every day on ADLs. (PS I am full of resentment about eating at the moment. I went resentful grocery shopping today and I still resent it.)
I had a bad experience with OT here (not the UK). What you mentioned in the post is what I expected I would find, which is why I was excited to be refered by my psychiatrist. Instead, I found an OT who told me she had no idea what to do with me because she had almost no experience with mental patients and the ones she did have were so sedated or compromised she just made them sit and draw flowers or put together simple puzzles. So she said that I’d have to come up with an idea of an activity. I smiled and played along and never went back.