Living in a glasshouse: exploring occupational alienation.

BACKGROUND Community mental health care has shifted focus from resettlement to empowerment, reflecting a wider agenda for social inclusion. PURPOSE This study evaluated mental health day services from the perspectives of thirty-nine clients. METHOD Data analysis of the four focus groups explored the implications for occupational therapy. The data collected were subjected to constant comparative analysis and theoretical sampling. RESULTS Participants described how mental health day services structured their day and enabled access to support networks. However, many perceived aspects of the services as fostering their dependence and threatening sessions they valued. This dependency led to them feeling alienated and wishing to seek greater influence over decisions about their current and future life. The concept of occupational alienation was used to further interpret their situation. PRACTICE IMPLICATIONS Occupational therapy could overcome occupational alienation experienced by mental health day service clients, through the development of services within and beyond day services which promote a sense of belonging and offers meaningful occupation.