Mental health exam

• Mental illness is not a life sentence
• Mental illnesses are not all the same
• People who are mentally ill are not necessarily violent
• Some cultural groups are not more likely to experience mental illness
• Occupational Therapy approach


  • Facilitate engagement in meaningful occupation
  • Address environmental barriers (physical/social) that restrict participation
  • Working together to create opportunities to overcome barriers
  • Create opportunities for participation
  • Enabling skill development
  • Collaborative problem-solving
  • Strategies for environmental adjustment
  • Person-centred practice
• Interpersonal skills needed


  • Therapeutic communication
  • Establishing relationships
  • Interviewing skills & strategic questioning
  • Understanding families & social systems
  • Understanding and managing difficult behaviour
  • Resolving empathic breaks and conflicts
  • Therapeutic use of self & self-care
• MOHO


  Foundational model in occupational therapy that addresses how volition, habituation, and performance capacity interact within the environmental context to influence occupational participation
• What are Key elements of MOHO

  • Volition
  • Habituation
  • Performance Capacity
• Why MOHO?


  • It is versatile, applicable across all ages, and useful in various settings
  • MOHO provides a comprehensive array of tools for assessment and intervention, making it suitable for clients facing occupational challenges
• Intrinsic Motivation


  MOHO prioritizes intrinsic motivation, where interventions are designed to engage clients actively in meaningful activities, fostering personal growth and satisfaction
• Dimensions of Occupation


  • Occupational Participation: Engaging in meaningful routines like self-care or work
  • Occupational Performance: The actual doing of tasks such as preparing a meal or completing an assignment
  • Occupational Skill: Includes motor, process, and communication skills necessary for effective task completion
• Therapeutic Change


  Driven by clients' engagement in meaningful activities, the therapy process in MOHO involves continual adjustment and real-world application
• The DSM-V and ICD-11 are critical tools used in mental health service settings for diagnosis and outcome data collection
• The DSM-V shift towards a dimensional assessment approach offers a more nuanced understanding of mental health conditions
• Mood Disorders


  • Major depressive disorder
  • Bipolar I disorder
  • Bipolar II disorder
  • Cyclothymic disorder
• Anxiety Disorders


  • Generalized anxiety disorder
  • Panic disorder
  • Agoraphobia
  • Social anxiety disorder
• Impact of mood and anxiety disorders on occupations


  Symptoms such as low motivation, fatigue, anxiety, and cognitive impairments can disrupt work, social interactions, and self-care routines
• Common medications for depression and anxiety


  • SSRIs (e.g., Citalopram, Escitalopram)
  • SNRIs (e.g., Duloxetine, Venlafaxine)
• There is an ongoing debate about the efficacy of serotonin in treating depression, as highlighted by recent studies questioning the impact of antidepressants on quality of life
• Assessments and Interventions


  • MOHOST
  • Occupational Self Assessment
  • Specific approaches tailored for mood and anxiety disorders
• Role of OTs in suicide risk assessment and management


  • Identifying risk factors and protective factors
  • Employing effective communication strategies to manage and intervene in cases of heightened suicide risk, such as using the QPR (Question, Persuade, and Refer) technique
• Positive Symptoms of Schizophrenia


  • Hallucinations
  • Delusions
  • Disorganized thinking
  • Disorganized behaviours
• Negative Symptoms of Schizophrenia


  • Flat affect
  • Social withdrawal
  • Difficulty in initiating activities
  • Lack of motivation
• Negative symptoms often have a greater impact on functioning, relating to early onset and poorer outcomes due to associated cognitive impairments
• Delusions


  Distorted thoughts or false beliefs that are not amenable to change despite conflicting evidence. They can be bizarre (impossible) or non-bizarre (possible but untrue).
• Hallucinations


  Perceptual distortions, often auditory, occurring without external stimuli, and not under voluntary control.
• Disorganized Thinking (Thought Disorder)


  Inferred from speech patterns that might include rapid topic shifts or incoherent speech.
• DSM-V criteria for schizophrenia diagnosis include exhibiting two or more symptoms during a significant portion of a 1-month period, with a marked decline in function: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms.
• Impact of schizophrenia on occupational functioning


  Schizophrenia significantly impacts occupational performance due to symptoms that distort reality and affect motivation and social interaction, leading to challenges in maintaining employment, education, and social relationships.
• Common antipsychotic medications and their occupational impact


  • Clozapine
  • Risperidone
  • Side effects such as sedation, movement disorders, and metabolic issues like weight gain and diabetes, impacting daily functioning and ability to engage in occupations
• Personality Disorders


  Patterns of experience and behaviour that are significantly different from the norm, persistent, inflexible, and lead to distress or impairment.
• Borderline Personality Disorder (BPD)


  Characterized by instability in interpersonal relationships, self-image, and affects, along with marked impulsivity. Symptoms impact occupational engagement as emotional instability can affect consistency and reliability in tasks.
• Mental State Examinations (MSE) in Clinical Practice


  A systematic collection of data based on the observation of a client's behaviour and mental processes.
• Antipsychotics


  Medications that can cause side effects such as sedation, movement disorders, and metabolic issues like weight gain and diabetes, impacting daily functioning and ability to engage in occupations
• Personality Disorders


  Patterns of experience and behaviour that are significantly different from the norm, persistent, inflexible, and lead to distress or impairment
• Borderline Personality Disorder (BPD)


  Characterized by instability in interpersonal relationships, self-image, and affects, along with marked impulsivity. Symptoms impact occupational engagement as emotional instability can affect consistency and reliability in tasks
• Mental State Examination (MSE)


  A systematic collection of data based on the observation of a client's behaviour and interactions. It's integral to every mental health assessment, helping in understanding the client's current state of mind and functioning
• Cultural beliefs can influence the perception of symptoms like delusions, and gender differences can affect the presentation and progression of schizophrenia
• Risk and prognosis factors include genetic predispositions and environmental factors such as complications during birth or higher paternal age
• Process of OT Assessment


  1. Data Screening

  2. Assessment Selection and Administration

  3. Occupational Profile Generation

  4. Occupational Performance Analysis

  5. Goal Setting and Re-evaluation