Occupational Therapy for Parental Mental Illness Through Early Intervention Programs

SIGNIFICANCE: There are few options for parents with mental illness to access occupational therapy. Early Intervention (EI) is a nationwide program providing services to families in the home. In this study, we explore the role of EI in supporting parents with mental illness, and how occupational therapists are involved as adult mental health practitioners.

INNOVATION: Estimates show that up to 23% of children live in homes with one or more parent with mental illness. Parental mental illness affects the whole family and can have a negative impact on children: decreased social participation; lowered psychological and physical health; and increased behavior, developmental, and emotional problems. Occupational therapists in EI have the potential to exert a positive impact on the lives of the child and family as a whole by being utilized as adult mental health practitioners.

APPROACH: Research indicates that the majority of adults with mental illness are parents. Families affected by parental mental illness are more vulnerable, experience social isolation, and show decreased family task accomplishment. There is need for increased services for the whole family rather than the adult or child as individual clients. EI has been highlighted as an appropriate platform for service delivery to parents with mental illness. There is little research on the use of occupational therapists in EI as experts in adult mental health. The questions this study seeks to answer include the following: Are EI programs working to meet the needs of families with parents with mental illness? Which service providers are typically assigned to these families? Are directors aware of occupational therapists’ role and training in mental health practice?

The study design is a qualitative online 20-question survey. EI directors were e-mailed with a description of the study and link for the survey. We contacted 44 directors, and 29 surveys were completed. Quantitative data were analyzed as descriptive statistics—frequency counts and percentages. Qualitative data were analyzed for key themes.

RESULTS: Of programs surveyed, 41% identified services for parents with mental illness as part of their mission statement. Programs reported outside referrals as the primary approach when working with parents with mental illness. Barriers were discovered that limit the use of occupational therapists as adult mental health practitioners; these barriers were either systematic or perceptual. Systematic barriers included limited numbers of occupational therapists and a high need for other occupational therapy services. Perceptual barriers included occupational therapists having a strong role identification as motor and sensory therapists, occupational therapists being viewed as having limited training in adult mental health, and occupational therapists being reported to not consider adult mental health as part of their focus.

CONCLUSION: There are limited options for parents to access occupational therapy for mental health services; in this study, we investigated the current utilization of EI occupational therapists in this capacity. The most common approaches reported for working with parents with mental illness were outside referral and assignment of the social worker. On the basis of the results of this study, there are systematic and perceptual barriers that frequently keep occupational therapists from being utilized as adult mental health specialists in EI. The main limitation of this study is the small sample size, which limits the quality of data analysis that could be completed.