Towards an understanding of occupational therapy professional practice knowledge in mental health services

Abstract

This study critiqued historical, philosophical and political factors influencing occupational therapy (OT) professional practice knowledge in the context of public mental health services located in Victoria, Australia. The research was situated within the interpretive paradigm of scientific inquiry, using a hermeneutic process to construct and interpret five texts portraying the evolution of OT in mental health services. A series of conversations with key occupational therapists yielded material for further critical interpretation. Ethical approval was received from the Human Ethics Committee, University of Sydney. The first constructed and interpreted text situated early mental health services within the unique background of Australian convict settlements, 1788 - 1868. OT emerged within institutional environments echoing this past. The second and third texts interpreted OT professional literature, presenting a timeline of practice within mental health services. Occupational therapists implemented their craft-based practice within the psychiatric institutions of the 1940s and 1950s. Through the next two decades, occupational therapists made efforts to align practice with medical paradigms of knowledge before returning to occupation as a core of practice knowledge in later decades. Following closure of institutions during the 1990s, occupational therapists were challenged by relocation of services to community-based, multidisciplinary environments. The fourth text portrayed an interpretation of four transitions of practice, reflecting challenges influencing professional practice knowledge through five decades of practice. The final text interpreted six strands of professional practice knowledge, representing unifying threads woven through these decades. The study concluded that OT had a quiet, yet consistent role within mental health services in Victoria. Gender, changing social views and practice environments were significant influences on the evolution of occupation as a core of practice. The study adds to deeper understanding of the importance of practice knowledge for the development of the profession in complex socio-political environments.