The Impact of a Therapeutic Recreation Program on Community-Based Consumers of a Regional Mental Health Service

Abstract

Over the last two decades, the deinstitutionalisation process has resulted in the movement of mental health consumers from institutional into community living. Today, this still continues to be a challenge for people with mental illness, other members of their social support network as well as service providers who are working with them in the community. Importantly, this on-going transition has highlighted the fact that many consumer needs have been largely unfulfilled throughout this inclusive process. One of these unmet needs has been the lack of provision of appropriate leisure services for people with a mental illness (Pegg & Moxham, 2000). Historically, leisure services in Australia have suffered from a lack of recognition by various state mental health services. Because of this, Dowla (1997) and Cassidy (1996) have strongly argued that there is a need for further empirical research to be undertaken to explore the belief that leisure has a positive effect on an individual’s health and wellbeing, and that leisure services are an important element of mental health service provision.

The main purpose of the study was to explore the relationship between leisure participation and the health and well-being of a sample of 62 community-based consumers of a mental health service in a regional city in Australia. The authors undertook a quasi-experimental design using a leisure intervention and a pretest, post-test and six-month follow-up procedure to examine the variables of perceived control and self-efficacy. Perceived Control in Leisure was measured by using the Short Form (Version B) of the Leisure Diagnostic Battery (Witt & Ellis, 1989). Self- Efficacy was measured by using the Leisure Efficacy Interview (Western Laboratory for Leisure Research, 1992). The therapeutic recreation intervention was undertaken for a three-hour duration, once a week for a period of 24 weeks. The leisure activities were mainly arts and craft based and were led by occupational therapy staff of the mental health service. Activities were offered as four-week modules or blocks so that there was sufficient time provided for participants to learn the rudimentary skills of the activity. Assignment was one of three groups of participants—autocratic, interactive and a comparison group.

The results of this study support the interactive style of instruction as a more effective method than relying on a traditional autocratic and directive style as it provides greater choices and opportunities for consumers. The findings of this study also support the importance of employing leisure therapy staff in case management teams who are cognizant of the need to establish a positive environment designed to facilitate the empowerment and quality of life of mental health consumers. Furthermore, the research findings provide additional support to validate the importance of leisure programs in community-based psychiatric facilities for people with a range of mental illnesses.