Level I Fieldwork: Inpatient Psychiatry

Hey readers! This semester I took my first occupational therapy practice class: OT in Mental Health. Since my practice class was in mental health, my fieldwork experience was as well. This semester, fieldwork was actually comprised of multiple experiences, which were:

  • A simulation to experience what it might be like to hear voices, such as what individuals with Schizophrenia may experience. – This in no way provided us with an experience of what it is like to have Schizophrenia or any other mental health condition. This simply provided us the experience of hearing voices while trying to accomplish basic everyday tasks, which is a symptom of some mental health conditions.
  • A simulated group assessment of a real patient with a mental health condition
  • Attendance of a support group – I attended a transplant support group
  • Naloxone training
  • Observation of occupational therapy in inpatient psychiatry

To learn more about the role of OT in mental health settings, check out AOTA’s page here. AOTA breaks it down by condition to describe the role of OT in mental health settings, as well.

My Experience in Inpatient Psychiatry

I had a great experience during my time observing occupational therapy in an inpatient psychiatry setting. My experience was on a locked unit for only one morning, so I didn’t see as much as I’d hoped. However, in that short time I was able to observe two groups and one individual treatment session, which were great! The setting was very hospital-like: white, harsh lighting, and no windows in the OT room. While this was a drawback, I thought that the supplies that the OT had and the availability of a sensory room was really beneficial to the unit. I’m sure each hospital has a different set-up and different access to resources, so this may vary across settings.

Group Sessions

The first group that I observed was a Rise & Shine group. During this group, the OT had coffee available for patients, and patients were free to arrive and stay for as long as they liked. The activity that the OT led was drawing a “Balanced Stool of Health,” which had three legs: self-care, productivity, and leisure/social-participation. The idea was that if any of the legs were too short or too long, then the stool would be unbalanced. I thought that this created a really great visual for patients to understand their various needs in order to maintain a healthy balance in their life. Each patient had the opportunity to write things that they need or want to do on each leg of the stool and then share with the group.

The Balanced Stool of Health

The second group that I observed was a Sensory Exploration group. This was my favorite of the two groups. The OT did a great job of starting off with education about why sensory tools are important and when and why you might need them, and then she provided various modalities for the patients to try. After trying different sensory tools, we discusses what everyone liked and did not like, and it was interesting to see how some people liked one tool while others thought it would not work for them. Some of the sensory tools the patients were able to try were:

  • Lavender lotion (my personal favorite and daily necessity!)
  • Beanbag tapping (check out this video if you don’t know what this is!)
  • Head massager (per patient request)
  • Stress balls & therapy putty
  • Weighted blanket/vest
A few of my nighttime lavender essentials:
Pillow mist, body lotion & essential oil

Individual Sessions

I only observed one individual session during this experience, and it was really short. It was actually more of a “meet and greet” than a true OT session. The patient had just been admitted, and the OT went to his room to introduce herself and to ask him a few questions. I think that the OT did a great job of building rapport by doing this. Some of the questions that she asked were about how she could make him more comfortable while he was there. She asked him about sensory tools that he might like to have while he was there (such as therapy putty or a weighted blanket), and she told him about her role as an OT. I would have loved to see a follow-up session with him or to have learned what his goals would be for OT.

Patient Progress Story

Believe it or not, in the short four hours that I was at this inpatient psychiatry setting I saw patient progress. The OT told us about one patient whose goal was to just simply attend groups throughout the day without any verbal interaction. She had severe social anxiety, which impacted her participation in daily occupations. In the first group that I saw, this patient did not say a single word or make eye contact. Later, when the OT invited the patients to introduce themselves during the second group, this patient spoke her name. This may seem like a tiny accomplishment, but the OT explained that for her this was huge. It was really cool to see this little bit of progress in the short time that I was observing.

How I Felt About My Experience

There is a lot of stigma in the United States around mental health. I’m not going to lie, I was a little bit more cautious and “on edge” at this setting than I have ever been in other settings. The OT told us about certain precautions and procedures that they have in place in case of emergency, and this was a locked unit, so I did have some reason to be more alert. However, the experiences that I had were great. The patients were friendly and really minded their own business and worked on their goals independently and with the group. I was surprised by how much I appreciated OT in the mental health setting after this experience. Is mental health for me? Probably not. But like I said, my experience was amazing!

Do you work in a mental health setting as a healthcare provider (OT or other profession)? Comment below!

Thanks for reading!

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