The restrictive environment of an acute ward

Competency number 2 of the Recovery Competencies for New Zealand Mental Health Workers states that "A competent mental health worker recognises and supports the personal resourcefulness of people with mental illness" (Mental Health Commission, 2001). This includes that the mental health worker must empower client's as much as possible (Mental Health Commission, 1998).

However, it is my belief that the inpatient mental health ward is a very restrictive environment which has strict timetables and rules. This is backed up by Goldsack et al (2005).

Within the ward clients can experience a lack of choice about what they want to do each day. Caltaux (2002) states that this limited choice and lead to negative self perception.

Another restriction of the acute inpatient mental health ward is that many patients in New Zealand will be under the Mental Health Act, 1992 to ensure their own and others safety. Being under the Act will create further restrictions for clients on the ward.

These restrictions can cause a feeling of disempowerment for clients. This feeling of disempowerment will make it harder to feel in control of recovery and may make it harder for clients to hold hope that they can live positively with a mental illness. Therefore, the setting is not conducive to empowering clients.

Within the ward there may also be a lack of resources, which can make it difficult for occupational therapists to empower clients. The first step in empowering people can involve offering them a choice about what they would like to do. Although an occupational therapist can ask clients what sort of activities they would like to do each day, it may be difficult to follow through on the expressed desire. For instance, a client may express a want to do woodwork. However an occupational therapist may not be able to assist in this task on the ward due to the risk perceived about the tools required, such as hammers, nails and saws.

A possible way around this is to let the client to certain aspects of the task - for example the OT could carry out some parts of the woodwork, and the client could paint it and decorate it.