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Mental illness frequently affects a person’s ability to do the activities that are part of their daily routine, such as grooming, hygiene, household tasks, money management, driving, work, socializing, etc. Occupational Therapists in this acute inpatient setting work with clients to determine their skills, abilities and any needs resulting from their illness. This is accomplished through formal and informal interviews, specific occupational therapy evaluations, observation and standardized assessments, which focus on behaviour and cognitive function (i.e. attention span, memory concentration, problem-solving, scanning, etc.). Analysis of assessments helps to determine a client’s response to medication, competency, safety, level of support and resources needed after discharge. Counselling and/or education, when possible, may be provided to assist clients and their families/caregivers, in planning, problem-solving and setting realistic goals. Referrals and recommendations are made to community resources to help the client in their return to home, to new living arrangements, to work, or in making lifestyle adjustments. 
Psychiatric Consultation Liaison TeamPhysical illness and injury usually affect many parts of a person’s life, not just the physical body. Therefore, to help people fully recover, we must consider the experiences, relationships and interests of the whole person. The Psychiatric Consultation Liaison Team bridges the mind-body gap by considering the life context of a person’s illness or injury. The Occupational Therapist on this team evaluates:
When these three areas don’t ‘fit’ well together because of illness or injury, the Occupational Therapist helps the patient, family and health care team find ways around these problems so the person can return to living in a way meaningful to them.
Mental Health Day HospitalIn the Day Hospital, assessment of a patient’s cognitive function and behaviour is achieved through structured group activities and/or individual sessions. Treatment is provided through group and/or individual sessions to promote the development of life skills, social skills and leisure skills.
Seniors Mental Health ClinicThe Seniors’ Mental Health Clinic is an ambulatory clinic that provides psychogeriatric assessment, treatment and follow-up to individuals aged 65 and over. The Clinic’s mandate is to maintain individuals in the community and to prevent admission or re-admission to inpatient psychiatry. As a member of a team of health care professionals, which currently includes a Psychiatrist, Registered Nurse and Social Worker, the Occupational Therapist provides services both in the Clinic and in the individual’s home environment. Assessment and treatment of the person (cognitive, affective, physical, spiritual), occupation (functional evaluation), and environment (home safety, caregiver coping), and referrals to community resources make up the current occupational therapy role. As the Clinic continues to evolve and expand, so will the role of the Occupational Therapist.
Geriatric Mental Health UnitThe Geriatric Mental Health Unit (GMHU) serves a diverse elderly population, all of whom present with psychiatric and/or dementing illness, but also who often may have concomitant neurological, cardiovascular, respiratory, orthopaedic, rheumatic and diabetic conditions. The role of the Occupational Therapist is threefold: functional assessment, provision of therapy, and discharge planning recommendations. As this is an acute care unit, a functional assessment is used to determine how the person’s ability or disability will impact discharge plans. Capabilities in the cognitive, physical and affective domains are assessed, as well as the person’s activities of daily living (ADL) and instrumental activities of daily living (IADL). Cognitive functional assessment includes the person’s perception, concentration, memory, comprehension, problem solving, ability to learn, and reasoning. Physical functional assessment includes sitting/standing tolerance, mobility, pressure relief and wheelchair needs. Affective functional assessment includes interpersonal interaction, intrapersonal self-worth, socialization and ability to cope with grief, anger, or stressors. ADL assessment evaluates transferring, dressing, grooming, bathing, toileting and feeding, whereas IADL assessment evaluates meal preparation, financial management skills, shopping and use of telecommunication and transportation services. Therapy involves skills training and adaptation of the environment to promote autonomy, safety and quality of life. Also, wheelchair seating and mobility aids may often be prescribed, and application for ADP funding also inititiated. The Occupational Therapist helps determine the person’s ability to learn and improve in function. Therefore, the Occupational Therapist also liaises with the discharge planner and provides recommendations as to the person’s ability to return home, move to a supervised setting, or try transitional care or medical rehabilitation. Peel Geriatric Mental Health ServicesAs a member of a team of health care professionals, the Occupational Therapist is responsible for conducting comprehensive psychogeriatric assessments with adults over the age of 65 who are experiencing mental health issues and/or cognitive impairment. Assessments are conducted in the individual’s home environment that could include a retirement home or long-term care facility. Recommendations to enhance the individual’s wellbeing, safety and functional abilities are made to the family physician, client and caregiver. Referrals to community agencies are initiated as appropriate. The Occupational Therapy role generally follows a consultation model. However, follow-up is provided to the client and caregiver on a limited basis.
OT Role in an Assertive Community Treatment Team (ACTT) ProgramTrillium has two ACTT programs that accept referrals from Mississauga and south Etobicoke. Assertive Community Treatment Team (ACTT) is a community program for adults with severe and persistent mental illness who require long term, intensive, comprehensive and individualized services. These services are intended to assist people to decrease their need for hospitalization and help people live more successfully in the community. Some of the services include identifying goals, providing support, monitoring symptoms and promoting appropriate medical treatment, crisis intervention, advocacy and skills teaching). The Occupational Therapist has many general responsibilities that are shared by the different professionals working on an ACT team. As well, the Occupational Therapist works together with the client to evaluate and improve their abilities to carry out in a safe way, their daily tasks and chores and their roles in life such as mother, volunteer, spouse, etc. The Occupational Therapist also helps the client to find meaning, balance and satisfaction in their lives and nurture their souls. The Occupational Therapist discusses and shares her information with the other professionals. Since ACT teams are relatively new, the Occupational Therapist’s role is new and both are in the developmental stage.
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