Occupational science has uncovered humans as “occupational beings” with an innate need to engage with the world, creating and maintaining health and wellbeing through being healthily “occupied”. Dysfunction in life roles manifests as discord in three domains: the individual, occupation and, environment.
- individual: health problems and a sense of “dis-ease” such as depression, substance use, lost confidence to pursue goals
- occupation: ineffective performance, reduced participation, insufficient standards, maladaptive for environment
- environment: poor access & participation in community, services, social or physical environment
Occupational justice: starting point to develop the OT role
Opportunity to engage in meaningful occupations is a prerequisite to survival, health and wellbeing. As such, it is a human right. Occupational justice seeks to create systems that enable all people and communities to access occupational repertoires necessary for healthy development and community function.
OTs have a role to advocate and intervene wherever occupational injustice compromises individual or community health and wellbeing. OT history is peppered with such pioneers.
Occupational chaos: The context of the OT role
The refugee highway is a journey with some well worn paths. "War-before-the-war", suddent flight, refugee camps, people smugglers, poverty on the streets, detention and finally settlement. Throughout the journey, refugees face enormous occupational challenges. These impact day to day occupational functioning.
New patterns of occupational engagement reflect new roles thrust into the fore and loss of familiar occupations. New physical, social and service environments require different living skills. Refugees must adapt to these new roles and environments despite circumstance stripping personal strengths such as language and traditional supports.
Ocupational deprivation: OT role with individual and environment
Refugees and asylum seekers also experience grotesque occupational deprivation explicitly (eg detention centers) and implicitly (eg policies, community attitudes). When these environmental influences preclude access to occupation over a prolonged period of time, the occupational deprivation perpetuates the trauma, dysfunction and deprivation associated with the refugee experience.
Engaging in relevant occupations that support life roles is a powerful vehicle for adapting, remoulding identity, building hope, developing a sense of mastery and belonging. OTs assess individual strengths, problems, life roles, occupations and the contextual environment to create specific occupational opportunities that enable function.
OT Action: A constellation of roles
Occupational therapists have a tremendous contribution to make in a constellation of roles.
OT Services. Enabling function with refugees.
- Mental health outreach team
- Torture and trauma service
- Private practitioner
- Local health clinics
- Settlement agencies
- Case management
- Project management
- Coordinate community agency
Research. Exploring, documenting and disseminating.
- OT student project
- Programme evaluation
- Honours project
- Quality assurance project
- Masters/PhD
- Evidence base review
Education. Occupational issues, intervention frameworks.
- OTs colleagues
- OT students
- Multicultural sector
- Refugees
- Broader community
Advocacy. Together is better!
- Collaborate in local health & advocacy networks
- Use State, National & World OT Associations
