“If you want to work, let's work out how to make this happen”: An interpretive description study of occupational therapists' perspectives of supporting young adults experiencing psychosis with their employment

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INTRODUCTION: Young adults experiencing psychosis want to work but most of them do not, even though success in employment and careers is possible. Occupational therapists are ideally placed to support young adults experiencing psychosis with employment, but evidence on contemporary occupational therapy practice in this area is lacking. This study asked occupational therapists who work with young people experiencing psychosis to share their perspectives about employment support. METHOD: An interpretive description study design was used with data collected through a focus group of expert informant occupational therapists. Data were analysed using thematic analysis. CONSUMER AND COMMUNITY INVOLVEMENT: There was no consumer and community involvement. RESULTS: Seven occupation therapists (4 to 23 years' experience) participated. All supported young adults experiencing psychosis who wanted to work. They perceived occupational therapists as using direct and indirect service provision. Direct service provision comprised person-centred occupation-focused employment support interventions to build occupational performance skills and explore and help secure potential work roles and career opportunities. Indirect service provision involved advocating inside mental health systems for work as a valid and valuable intervention goal if this is what the young person wanted; simplifying pathways in mental health and employment service systems; adopting early intervention approaches to employment support; and identifying enabling social and employment contexts. CONCLUSION: Occupational therapists perceive current practice involves integrating an occupation-focused person-centred approach to employment support within their roles, which may be interdisciplinary. They use direct and indirect service provision. Direct focused on the young person; indirect occupational therapy focuses on mental health, employment and social environments experienced by the young person. Early intervention, rather than traditional vocational rehabilitation, is the approach used. This study presents a contemporary description of occupational therapy employment support practice in mental health services for young people experiencing psychosis.

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