Occupation, identity and belonging within community: experiences of mental health disability

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Cassidy, Caoileann
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University College Cork
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Background: This is a qualitative research study exploring the perspectives of Irish people with self-reported mental health disability in participating in occupation within their community environments. The relatedness of occupation to health and the concept of belonging requires further research and understanding within the discipline of Occupational Science and within the practice of Occupational Therapy. Methodology: Purposive sampling was employed to recruit three participants, from one national mental health support organisation. A phenomenological and narrative framework was adopted in this research. This informed the use of narrative interviews and observation methods to gather data about occupations enacted by participants within their community environments. Open ended narrative interviews were adopted to encourage storied accounts of participants’ experiences, with each participant engaging in two interviews. Following the first interview, each participant collaborated with the researcher in planning an observation session, with the researcher as complete participant, in a chosen occupation within their local, familiar environment. Following this each participant engaged in a second interview with the researcher. Data Collection and Analysis: Digital audio recordings were transcribed anonymously and verbatim from interviews, coupled with field notes from observations, using thematic analysis. This analysis upheld the integrity of each story while illuminating shared meaning of participants’ chosen occupations. Findings: In answer to the research questions, two primary themes were identified, with each theme encompassing two subthemes. The first theme “Experiencing Normality and Promoting Health” explores how participants in this study experienced feeling or anticipated feeling normal through their participation in occupation. Additionally, they chose occupations to promote their physical and mental health when navigating changes to their identities as a result of their mental health distress or disability. The second theme was “Meaning Making and Experiences of Inclusion and Exclusion within Community” exploring participants meaning making through occupation in their local environments, within places and amongst others. The first subtheme captures how participants participated in meaning making with others. The second focuses on their experiences of inclusion and exclusion with stigma emerging from their surrounding environments, impacting feelings of belonging. Discussion: The findings of this study inform understanding of occupation and expand knowledge of its relationship to health, specifically mental health. It contributes to existing research concerning the impact of the social world on a person’s occupational choices, possibilities and resultant identities. Further these findings have elicited greater understanding about the meaning of these occupations to participants and how this enabled their participation through “being” and “belonging” in their communities. Conclusion: The results of this study contribute to theory generation of occupation within the discipline of occupational science and to the clinical practice of occupational therapy. The findings of the current research indicate that stigma and experiences of exclusion prevail for people with mental health disabilities. Results also find that participation in occupation, within affirming environments can create experiences of normality and promote health. Further, participation in occupation fosters experiences of inclusion and belonging.
Occupation , Belonging , Identity , Community , Experiences of mental health disability , Occupational therapy , Occupational science
Cassidy, C. 2020. Occupation, identity and belonging within community: experiences of mental health disability. MRes Thesis, University College Cork.