November 12, 2018

Mental Health Occupational Therapy (Behaviour Support)

What is Mental Health Occupational Therapist?

Recovery Station has a team of experienced Occupational Therapists (OTs) that are endorsed and specially trained to provide Mental Health services. Our Mental Health OTs are registered providers with the NDIS to provide psychosocial supports (stated as NDIS Plans through ‘Improved Daily Living’ and ‘Improved Relationships’), that focus on capacity building of an individual’s functional independence and social or economic participation. Recovery Station provides Mental Health services for adolescents and adults and all level of need.

Why Engage a Mental Health Occupational Therapist?
Occupational therapists in mental health work to increase an individual’s ability to live as independently as possible in the community while engaging in meaningful and productive life roles. OTs achieve this by helping clients address barriers to achieving their goals through interventions that focus on enhancing existing skills, creating opportunities, promoting wellness, remediating or restoring skills, modifying or adapting the environment or activity, and preventing relapse. It can significantly benefit an individual’s ability to participate and engage in the community and daily life activities and routines that are meaningful to lead productive lives.

Occupational Therapists work in achieving an optimal state of personal, social and emotional wellbeing, as defined by each individual. This includes an individual’s life skills to enhance everyday functioning within life skill areas, such as:

  • Social Interaction
  • Self-Care
  • Self-Management
  • Communication
  • Learning
  • Mobility

What does Mental Health Occupational Therapy look like for a client?
Mental Health OTs help clients who struggle, feel overwhelmed or hopeless trying to cope with psychological or emotional challenges. This may include having trouble sleeping, concentrating, communicating, functioning normally within their local community, or getting out of bed in the morning. Strategies used by mental health OTs may include:

  • Assessing and adapting the environment at home, work, school, and other environments
  • Providing individual or group therapy and educational programs to address assertiveness, self-awareness, interpersonal and social skills, stress management, and role development.
  • Working with clients to develop leisure or avocational interests and pursuits
  • Facilitating the development of skills needed for independent living such as using community resources, managing one’s home, managing time, managing medication, and being safe at home and in the community
  • Providing training in activities of daily living (e.g., hygiene and grooming)
  • Conducting functional evaluations and ongoing monitoring for successful accommodation and job placement
  • Providing guidance and consultation to persons in all employment settings, including supportive employment
  • Providing assessment and treatment for sensory processing deficits
  • Providing education and support for service providers working with clients with mental health issues to ensure optimal support and care is provided with a focus on developing consistency for the client, safety for the client and care provider, and maximising skill building.

We work with people who are living with, or recovering from, a mental health condition. This includes:

  • Have self-harming behaviours
  • Have aggression towards others
  • History of breaking objects / third party damage
  • History of absconding and wandering
  • Sexually inappropriate behaviour
  • Have withdrawn from others
  • Are isolated from friends and family
  • Have no sense of motivation
  • Have become forgetful, unable to concentrate and/or often feel disoriented
  • Have stopped performing normal daily activities, such as cooking, shopping, and cleaning
  • Are having difficulty maintaining daily hygiene habits
  • Have loved ones or others express concern over their behaviour
  • Are experiencing disordered thinking and/ or altered perceptions of reality

The types of assessments we use are a variety of functional assessments:

  • World Health Organisation Disability Assessment Schedule (WHODAS)
  • Life Skills Profile 16 (LSP-16)
  • Health of the Nation Outcome Scale (HONOS)
  • Sensory Profile
  • Numerous Standardised Cognitive Assessments
  • Overt Behaviour Scale
  • Functional performance review

Assistive Technology – Is it a Restrictive Practice?

If assistive technology (equipment) is prescribed for behaviour management under the NDIS, a Behaviour Support Plan (BSP) is required –

  • Any AT that is prescribed to manage behaviour would be considered mechanical restraint. This can include bed rails, tilt function on wheelchairs, chest harnesses, lap belts, tray tables and car and wheelchair harness, etc. This means that participant equipment requirement could be considered a restrictive practice and will now need a BSP with Restrictive Practice in place. At the assessment, information about why the equipment is being used is gathered to determine if the equipment can be classed as a Health/ Medical Support Practice or a “Non-Purposeful” Risk mitigation tool.
  • If the assistive technology is specific to a safety / therapeutic device or practice, or is being used to manage a “non purposeful” risk behaviour and is not a restrictive practice as it is not intended to address behaviours of concern (e.g., if the primary purpose of the device or practice is to control or restrict the person’s behaviour or free movement), it does not need to be supported by a BSP. However, if at any time following the implementation of this recommendation, a person objects to a therapeutic or safety device or practice, its application may be considered a restrictive practice. In such cases, a BSP will be required and the Restrictive Practices Authority (RPA) processes will apply.
  • Family and Community Services have carriage over the Restrictive Practice Authorisation Policy. To view the policy, click here.

The Behaviour Support Practitioner will work with the participant, their informal supports, and implementing provider to develop a behaviour support plan (BSP) that is based on a functional behaviour assessment. It specifies a range of evidence-based and person-centred, proactive strategies that focus on the individual needs of the participant. This includes positive behaviour support to build on the person’s strengths and increase their opportunities to participate in community activities and develop new skills. Each strategy is addressed separately and in detail with education being a key component.

One of the main aims is to reduce or eliminate the use of restrictive practices with the participant over time. The BSP must also include alternative positive behaviour support strategies (e.g. ecological supports, skill building, responsive strategies). The BSP is then registered with the NDIS Commission to enable monitoring of regulated restrictive practices.

We recommend that you keep updated with all your behaviours supports on the NDIS Commission website:

Recovery Station’s Behavioural Support Practitioners are NDIS Commission registered and experienced Mental Health Occupational Therapists. Participants requiring NDIS funding for behavioural supports and BSPs will access these supports through the support category “Improved Relationships”.