Therapeutic activities within Psychiatric Intensive Care and Low Secure Units

Faisal Kazi; Brenda Flood; Sarah Hooton

doi:10.1017/CBO9780511543593.014

11 - Therapeutic activities within Psychiatric Intensive Care and Low Secure Units

from Part I - Therapeutic interventions

Published online by Cambridge University Press: 22 August 2009

M. Dominic Beer ,

Stephen M. Pereira and

Brenda Flood and

M. Dominic Beer: Affiliation:
Oxleas NHS Foundation Trust
Stephen M. Pereira: Affiliation:
Goodmayes Hospital, Essex
Carol Paton: Affiliation:
Oxleas NHS Foundation Trust
Faisal Kazi: Affiliation:
BSc Hons OT, Senior Occupational Therapist, Oxleas NHS Foundation Trust, Bracton Centre, Darford Kent, UK
Brenda Flood: Affiliation:
Lecturer Department of Occupational Therapy, Auckland University of Technology, Auckland, New Zealand
Sarah Hooton: Affiliation:
Formerly Occupational Therapist, Oxleas NHS Foundation Trust, Bracton Centre, Dartford, Kent, UK

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Summary

Introduction

Therapeutic activities not only enhance an individual's development, but they can also assist in the management of problematic behaviour and maintenance of a safe environment. The importance of providing therapeutic activities within a Psychiatric Intensive Care Unit (PICU) is highlighted in the National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units and Low Secure Environments:

An effective PICU design will have given the provision of therapeutic activity an equal status to safety and security.

(Department of Health 2002a, p. 13)

The range of activities that can be offered within a PICU requires careful consideration in order to meet the acute, complex and challenging needs of the patient population. Clinicians are faced with the task of identifying appropriate strategies and ensuring the necessary structures and systems are in place in order for therapeutic activities to be safely and consistently provided.

This chapter aims to provide clinicians with an introduction to the relevant literature supporting therapeutic activities and presents a practical approach towards developing and maintaning a therapeutic programme within a PICU/Low Secure Unit (LSU). It will explore the benefits and limitations of providing a therapeutic programme and describe how these activities can be effectively implemented within this specialised environment.

Activity

Activities are central to human existence and are vital to meeting basic human needs (Drew and Rugg 2001; Kielhofner and Butler 2002; Law 2002).

Type: Chapter
Information: Psychiatric Intensive Care , pp. 149 - 160

DOI: https://doi.org/10.1017/CBO9780511543593.014 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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References

Barker, P. 2001 Dismantling formal observation and refocusing nursing activity in acute in-patient psychiatry: a case study. J Psychiatr Mental Health Nurs 8(2): 183–188Google Scholar

Barlow, T. 2003 What colour is aggression?Mental Health Pract 7(4): 32–33Google Scholar

Barthwick, A, Holman, C, Kennard, D, McFetridge, M, Mes, sruther K, Wilkes, J. 2001 Relevance of moral treatment to contemporary mental health care. J Mental Health 10(4): 427–439Google Scholar

Bodin, T, EW, Martinsen. 2004 Mood and self-efficacy during acute exercise in clinical depression: a randomised, controlled study. J Sport Exerc Psychol 26: 623–633Google Scholar

Bradshaw, T, Lovell, K, Harris, N. 2005 Healthy living interventions and schizophrenia: a systematic review. J Adv Nurs 49(6): 634–654Google Scholar

Brown, S, Birtwistle, J, Roe, L, Thompson, C. 1999 The unhealthy lifestyle of people with schizophrenia. Psychol Med 29(3): 697–701Google Scholar

Callaghan, P. 2004 Exercise: a neglected intervention in mental health care?J Psychiatr Mental Health Nurs 11: 476–483Google Scholar

Carless, D, Douglas, K. 2004 A golf programme for people with severe and enduring mental health problems. J Mental Health Promotion 3(4): 26–39Google Scholar

Creek J. 2002 The knowledge base of occupational therapy. In: Creek, J (ed) Occupational Therapy and Mental Health, 3rd edn. Edinburgh: Churchill Livingstone

Crone, D, Heaney, L, Herbert, R, Morgan, J, Johnston, L, Macpherson, R. 2004 A comparison of lifestyle behaviour and health perceptions of people with severe mental illness and the general population. J Mental Health Promotion 3(4): 19–25Google Scholar

Daffern, M, MM, Mayer, Martin, T. 2003 A preliminary investigation into patterns of aggression in an Australian forensic psychiatric hospital. J Forensic Psychiatry Psychol 14(1): 67–84Google Scholar

AJ, Daley. 2002 Exercise therapy and mental health in clinical population: is exercise therapy a worthwhile intervention?Adv Psychiatr Treat 8: 262–270Google Scholar

Davenport, S. 2002 Acute wards: problems and solutions, a rehabilitation approach to in-patient care. Psychiatr Bull 26: 385–388Google Scholar

DCMS/Strategy Unit. 2002 Game Plan: A Strategy for Develivering Government's Sport and Physical Activity Objectives. London: DCMS/Strategy Unit

Department of Health. 2000 National Service Framework: Mental Health. London: HMSO

Department of Health. 2002a National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units (PICU) and Low Secure Environments. London: HMSO

Department of Health. 2002b Adult Acute In-Patient Care Provision. London: HMSO

Department of Health. 2004a Developing Positive Practice to Support the Safe and Therapeutic Management of Aggression and Violence in Mental Health In-Patient Settings. London: HMSO

Department of Health. 2004b At Least Five a Week: Evidence on the Impact of Physical Activity and it's Relationship to Health. London: HMSO

Department of Health. 2004c Choosing Health: Making Healthier Choices Easier. London: HMSO

Dombrovski, A, Rosenstock, J. 2004 Bridging general medicine and psychiatry: providing general medical and preventative care for the severely mentally ill. Curr Opin Psychiatry 17(6): 523–524Google Scholar

Drew, J, Rugg, S. 2001 Acivity use in occupational therapy. Br J Occup Ther 64(10): 478–486Google Scholar

Edwards, S. 2002 Physical exercise and psychological wellness. Int J Mental Health Promot 4(2): 40–46Google Scholar

Eklund, M, LK, Erlandsson, Persson, D. 2003 Occupational value among individuals with long-term mental illness. Can J Occup Ther 70(5): 276–284Google Scholar

Faulkner, G, Biddle, . 2001 Exercise and mental health: it's not just psychology!J Sports Sci 19: 433–444Google Scholar

Faulkner, G, Sparkes, A. 1999 Exercise as therapy for schizophrenia: an ethnographic study. J Sport Exerc Psychol 21: 52–69Google Scholar

Faulkner, G, AA, Soundy, Lloyd, K. 2003 Schizophrenia and weight management: a systematic review of interventions to control weight. Acta Psychiatr Scand 108(5): 324–332Google Scholar

Foster M. 2002 Theoretical frameworks. In: Turner, A, Foster, M, Johnson, S (eds) Occupational Therapy and Physical Dysfunction: Principle Skills and Practice, 5th edn. Edinburgh: Churchill Livingstone

KR, Fox. 2000 Physical activity and mental health promotion: the natural partnership. Int J Mental Health Promot 2(1): 4–12Google Scholar

Greening, J. 2005 Physical health of patients in rehabilitation and recovery: a survey of case note records. Psychiatr Bull 29: 210–212Google Scholar

Hagedorn, R. 2001 Foundations for Practice in Occupational Therapy, 3rd edn. Edinburgh: Churchill Livingstone

RA, Hansen, Atchison, B (eds). 2000 Conditions in Occupational Therapy, Effect on Occupational Performance, 2nd edn. Philadelphia: Lippincott, Williams and Wilkins

Jones, M, O'Beney, C. 2004 Promoting mental health through physical activity: examples from practice. J Mental Health Promot 3(1): 39–48Google Scholar

Kelly, S, McKenna, H, Parahoo, K, Dusoir, A. 2001 The relationship between involvement in activities and quality of life for people with severe and enduring mental illness. J Psychiatr Mental Health Nurs 8: 139–146Google Scholar

Kielhofner, G, Butler, J (eds). 2002 A Model of Human Occupation: Theory and Application. Philadelphia: Lippincott, Williams and Wilkins

Law, M. 2002 Participation in the occupations of everyday life. Am J Occup Ther 56(6): 640–649Google Scholar

Lawlor, D, SW, Hopker. 2001 The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. Br Med J 322(7289): 763–767Google Scholar

Mee, J, Sumsion, T. 2001 Mental health clients confirm the motivating power of occupation. Br J Occup Ther 64(3): 121–128Google Scholar

Mee, J, Sumsion, T, Craik, C. 2004 Mental health clients confirm the value of occupation in building competence and self-identity. Br J Occup Ther 67(5): 225–233Google Scholar

National Institute for Clinical Excellence. 2002 Schizophrenia, Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. Clinical Guideline 1. London: NICE

Paterson CF. 2002 A short history of occupational therapy in psychiatry. In: Creek, J (ed) Occupational Therapy and Mental Health, 3rd edn. Edinburgh: Churchill Livingstone

Phelan, M, Stradins, L, Morrison, S. 2001 Physical health of people with severe mental illness: can be improved if primary care and mental health professionals pay attention to it. Br Med J 322(7284): 443–444Google Scholar

KL, Rebeiro, JV, Cook. 1999 Opportunity, not prescription: an exploratory study of the experience of occupational engagement. Can J Occup Ther 66(4): 176–187Google Scholar

Reynolds, F. 2001 Strategies for facilitating physical activity and wellbeing: a health promotion perspective. Br J Occup Ther 64(7): 330–336Google Scholar

CR, Richardson, Faulkner, G, McDevitt, J, GS, Skrinar, DS, Hutchinson, JD, Piette. 2005 Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv 56: 324–331Google Scholar

Royal College of Psychiatrists College Research Unit. 2001 National Audit of the Management of Violence in Mental Health Settings Final Report: Year 2. London: Royal College of Psychiatrists

Rutter, S, Gudjonsson, G, Rabe-Hesketh, S. 2004 Violent incidents in a medium secure unit: the characteristics of persistent perpetrators of violence. J Forensic Psychiatry Psychol 15(2): 293–302Google Scholar

Scully, D, Kremer, J, MM, Meade, Graham, R, Dudgeon, K. 1998 Physical exercise and psychological well being: a critical review. Br J Sports Med 32: 111–120Google Scholar

Secker, J, Benson, A, Balfe, E, Lipsedge, M, Robinson, S, Walker, J. 2004 Understanding the social context of violent and aggressive incidents on an in-patient unit. J Psychiatr Mental Health Nurs 11(2): 172–178Google Scholar

Shepherd, M, Lavender, T. 1999 Putting aggression into context: an investigation into contextual factors influencing the rate of aggressive incidents in a psychiatric hospital. J Mental Health 8(2): 159–170Google Scholar

Tilt, R, Perry, B, Martin, C, Maguire, N, Preston, M. 2000 Report of the Review of Security at the High Security Hospitals. London: Department of Health

Turner A. 2002 History and philosophy of occupational therapy. In: Turner, A, Foster, M, Johnson, S (eds) Occupational Therapy and Physical Dysfunction: Principle Skills and Practice, 5th edn. Edinburgh: Churchill Livingstone

United Kingdom Central Council for Nursing, Midwifery and Health Visiting. 2002 The Recognition, Prevention and Therapeutic Management of Violence in Mental Health Care. London: UKCC

World Federation for Mental Health. 2004 The Relationship Between Physical and Mental Health: Co-occuring Disorders. Alexandria: World Federation for Mental Health

World Health Organization. 2005 Promoting Mental Health: Concepts, Emerging Evidence, Practice. Geneva: World Health Organization

Yarwood L, Johnstone V. 2002 Acute psychiatry. In: Creek, J (ed) Occupational Therapy and Mental Health, 3rd edn. Edinburgh: Churchill Livingstone

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