Investigation of stakeholder perspectives on leisure activity in mental health inpatient units

Investigation of stakeholder perspectives on leisure activity in mental health inpatient units

This thesis aimed to understand the barriers and facilitators to leisure engagement in mental health inpatient units. Furthermore, this thesis explored the availability of leisure activity, evaluation of a leisure tool to identify preferences, and development of practice principles to improve leisure opportunities in acute settings. This thesis includes two literature reviews and five original research studies. This thesis applied the Model of Human Occupation (MOHO) to gain a greater understanding of consumers, occupations available, and the environment. Section one explored the contextual factors that contribute to the dearth of leisure activity in mental health inpatient units. The first original research chapter (chapter two) in this section explored the general population's value of leisure activities and explored the therapeutic use of leisure. The findings concluded that leisure is an activity most people participate in daily, and a definition of leisure was developed. A scoping review (chapter three) explored the consumer, staff, and carer perspectives of leisure activity offered in mental health inpatient units. The findings suggest that consistently consumers have reported being bored with a limited range of leisure activities offered. The staff (who provide direct service provision) perspective of the barriers and facilitators to consumer engagement was explored through an online anonymous survey (chapter four). Most staff (97%) believe there is a lack of meaningful activities offered to consumers in inpatient units but were unsure how to make changes to this problem. The macro or governance perspective (chapter five) of health was explored through a policy analysis of mental health acts and supporting policies from Australia, New Zealand, and the United Kingdom. A limited number of leisure-related concepts was found across 32 documents. Findings suggest an increase in leisure-related language may assist to facilitate leisure engagement conducive to recovery. Section two of the thesis reviewed methods to evaluate leisure preferences to implement in acute inpatient settings. This included the development of a leisure tool called the Checklist of Leisure, Interest, and Participation (CLIP) (chapter six). The findings suggest that the CLIP is a valid and reliable tool for exploring consumer interests. The consumer perspective (chapter seven) included consumers currently inpatient at the Princess Alexandra Hospital, Brisbane. Consumers completed an anonymous survey that included two standardised tools and a checklist : the Mental Health Satisfaction Improvement Program (MHSIP), Leisure Boredom Scale (LBS), and the Checklist of Leisure Interests and Participation (CLIP). Section three includes the development of practice principles (chapter eight) to facilitate leisure activity in mental health inpatient units. The practice principles draw from the literature and findings of this thesis.

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