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...but there are only so many hours in day.

When the new Deprivation of Liberty Safeguards (DoLS) were implemented in 2009, there were inevitable concerns about increased pressures on already stretched mental health and social care resources. However, it's not just psychiatrists, psychologists, mental health nurses and social workers who have faced new challenges.  The DoLS have also extended the remit of occupational therapists who, in many settings, have been expected to take on additional responsibilities, for example acting as Best Interest Assessors.

Occupational therapy may no longer be on the government's shortage occupation lists, however, across the UK there's a significant variation in demand for and supply of OTs. In 2008, the College of Occupational Therapists welcomed the opportunity for OTs to take on the new roles identified in the DoLS, saying that they would allow their members to "continue to modernise and improve their services". However, the College also warned that there was "likely to be an impact on available resources for undertaking the profession specific elements of their treatments/interventions".


Most mental health teams only have one occupational therapist. Time spent on DoLS work will naturally impact on capacity to provide traditional occupational therapy services. Careful planning is needed to ensure that DoLS commitments don't reduce access to vital therapy for mental health service users. Otherwise, the costs could outweigh the benefits. For example, OTs play a key role in helping those with mental health issues return to work. 40% of people who are unable to work because of poor mental health are claiming incapacity benefit, costing the taxpayer millions of pounds each year. 

Occupational therapists also face the challenge of reconciling the DoLS with the idea of 'personalisation' (ie recognising people as individuals who have strengths and preferences and putting them at the centre of their own care and support), which is now at the heart of mental health care strategy. As the Social Care Institute for Excellence puts it, "The philosophy of occupational therapy is founded on the concept that occupation is essential to human existence and good health and well-being. Being deprived of or having limited access to occupation can affect physical and mental health."

According to the draft statutory guidance for the Care Act 2014, social workers and occupational therapists are considered to be "two of the key professions in adult care and support" and should be available to help adults who need care, carers and assessors. Let's hope we're not trying to spread our occupational therapy resources too thinly.

Are you an occupational therapist or mental health team leader with views on the issues raised in this article? Leave your comments below.

 

 

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