An Argument for Guidelines for Capstones in Unhoused Settings.

In recent years, there has been increased interest in completing occupational therapy doctoral capstones with people experiencing homelessness. Given the complexity of practice with this population and its history of discrimination and marginalization, we argue for the development of guidelines for completing capstones in unhoused settings. In this column, we present background and contextual information, justification for the need for guidelines, and preliminary recommendations for consideration by students and faculty. Our aim is to invite reflection within the profession and among academic institutions and to promote dialogue with community agencies that serve this population to ensure that capstones are developed ethically, sustainably, and without unintentionally perpetuating harm.

Predictors of Population Mental Health in Montana: An Occupational Justice Perspective.

Population-level analyses can demonstrate occupational injustices and their impact on population health. The objective of this article is to examine whether population-level occupational factors are related to the mental health of Montanans. We used linear regression models of the 2021 Montana County Health Rankings to examine the association between occupational justice and mental health, adjusting for covariates. Predictor variables were access to exercise, insufficient sleep, healthy food access, food insecurity, proximal jobs, and social support. Outcome variables were frequent mental health distress and poor mental health days. Adjusted models showed significant associations between both insufficient sleep (ß = 0.25, 95% confidence interval [CI] = [0.0.11, 0.40]; Table 2) and food insecurity (ß = 0.32, 95% CI = [0.22, 0.43]) and poor mental health days z scores. Adjusted models also showed significant associations between insufficient sleep (ß = 0.18, 95% CI = [0.10, 0.26]) and food insecurity (ß = 0.19, 95% CI = [0.12, 0.25]) and frequent mental health distress. Future research should study whether targeting sleep and food security can enhance Montanans's mental health.

Predictors of Population Mental Health in MontanaA population-level analysis of Montana County Health Rankings using an occupational justice perspective revealed that food insecurity and insufficient sleep were associated with poor mental health days and frequent mental health distress.

Liminal Space of First-Episode Psychosis: Health Management and Its Effect on Social Participation.

IMPORTANCE: Managing health requires extensive time and effort, especially in the early stages of a new illness. Although important, health management occupations contribute to treatment burden, disrupt engagement in other occupations, and galvanize the incorporation of the illness into identity. This is especially true for young adults after first-episode psychosis (FEP). OBJECTIVE: To explore the impact of health management occupations on the social participation of young adults after FEP. DESIGN: Qualitative study. SETTING: Community with participants from primarily urban environments. PARTICIPANTS: Five adults between 18 and 30 yr old who experienced FEP within the previous 5 yr. Data collection occurred through semistructured interviews, participant observations, and discourse elicitation. Outcomes and Measures: Two participant observations per month for 6 mo with 4 study participants; six observations total for a 5th participant. RESULTS: Health management dominated participants' occupations immediately after FEP and hindered their social participation as they experienced a liminal space (i.e., transition space) in their life trajectory. Some participants were "stuck" in this space and deferred life goals to focus on illness management, whereas others used the liminal space as a space for growth and transformation. CONCLUSIONS AND RELEVANCE: Health management occupations are essential; however, overemphasizing health management can hinder social participation and quality of life. Occupational therapy practitioners can assist clients with moving through liminal spaces after diagnosis by supporting participation beyond mental health treatment environments, helping clients to imagine alternative life trajectories, and finding strategies to reduce overall treatment burden. What This Article Adds: The concept of liminality holds promise for understanding and supporting health management and social participation after FEP.

Doing Occupational Justice: A Central Dimension of Everyday Occupational Therapy Practice.

BACKGROUND.: The Canadian Association of Occupational Therapists (CAOT) and the American Occupational Therapy Association (AOTA) state that occupational justice is part of the domain of occupational therapy and that occupational justice is "an aspect of contexts and environments and an outcome of intervention" (AOTA, 2014, p. S9). KEY ISSUES.: Despite the increasing focus on justice in the occupational therapy and the occupational science literature, many practitioners in traditional settings do not see its relevance to their everyday practice (Galvin, Wilding, & Whiteford, 2011) or have difficulty envisioning how to enact a justice-informed practice. PURPOSE.: This paper demonstrates how occupational justice is germane to all settings of occupational therapy, and how it can be enacted at micro, meso, and macro levels of occupational therapy practice. IMPLICATIONS.: We argue that occupational therapy is a justice-oriented profession at its core and will discuss how occupational justice can be enacted at all levels of practice.

Linking Neuroscience, Function, and Intervention: A Scoping Review of Sensory Processing and Mental Illness.

PURPOSE: Sensory approaches to mental illness are increasingly prominent in occupational therapy. Despite indicators of efficacy, a paucity of literature supports these approaches. This article provides a scoping review of research on the relationship between sensory processing and mental illness. METHOD: Using Arksey and O'Malley's (2005) framework, we mapped this area of research and identified gaps in the knowledge base. We searched PubMed, CINAHL Plus, PsycINFO, OTseeker, and the Cochrane Library using the terms sensory and mental health. RESULTS: We found a growing body of neuroscientific research, primarily using electroencephalography and functional MRI, that links atypical neurosensory activity to mental illness. The occupational therapy literature has primarily focused on the efficacy of sensory rooms in psychiatric inpatient settings. CONCLUSION: Research on the efficacy of sensory approaches needs to be expanded, including on how atypical sensory processing in adults with mental illness affects meaningful occupational participation.

Habits of the Sensory System and Mental Health: Understanding Sensory Dissonance.

OBJECTIVE: In occupational therapy, research has studied sensory function predominantly in relation to sensory disorders. There is a gap in the literature exploring how sensory experiences affect mental health. This study sought to provide a phenomenological understanding of how people relate experiences of sensory dissonance to their mental health. METHOD: Ten immigrants from Latin America participated in semistructured interviews and video observations of their occupational behavior. RESULTS: Participants' experiences of sensory dissonance provoked negative mental states and distress. Participants reported poor mental health following sensory experiences that were incongruent with their habits of sensing. They also intentionally used sensory anchors to induce positive mental states and connect with past occupational experiences. CONCLUSION: Occupational therapy practitioners should be mindful of how sensory environments can facilitate or impede intervention. Practitioners are encouraged to harness clients' sensory habits and use sensory anchors as a form of sensory scaffolding to facilitate therapeutic gains.

Video methodologies in research: unlocking the complexities of occupation.

BACKGROUND: Video methods are used by numerous academic disciplines researching human action. Occupational therapists and scientists have primarily employed video data to enumerate subcomponents of occupational behaviour, to conduct reliability tests, and to study clinical reasoning. There is a gap in the literature using video data to explore complex dimensions of typical occupational behaviour. PURPOSE: This paper aims to encourage the use of video methodology beyond its current state in research on occupation. KEY ISSUES: Drawing on recent theoretical developments in the literature and empirical illustrations from a video-based project with migrants, this paper demonstrates thepotential contributions of video data to understandings of identity, the physical environment, the stream of occupations, and collective occupations. The paper also discusses the unique advantages and richness of collecting video data in comparison to interviews and traditional observations. The challenges in employing video methodologies are discussed. IMPLICATIONS: Video research offers unprecedented opportunities to study human occupation in incommensurable detail as it unfolds through sociocultural and physical environments.