Working as a Volunteer Occupational Therapist in

Sri Lanka

Sophie AllisonCentral and North-West London

Mental Health Trust

O u tlin e

1. Description of Placement setting2. Roles and Outcomes3. Challenges and considerations4. What I gained5. Any questions?

Placement Description: OT in Mental Health

• Based in Kandy Sri Lanka 2001-2004• Employed by NGO-Nivahana Society• Aims of NGO to develop, primary, secondary and

tertiary mental health services in the Central Province through partnership with the Ministry of Health

• Had used various VSO volunteers of past 10 -15 years including administrators , managers , SW, nursing and OT to share skills and develop services with local partners and organisations

OT Role

1) To work with local OTs to share skills and support development of their services

2) To support development of residential rehabilitation services

3) To introduce training in mental health community rehabilitation to primary care workers

1. Develop OT Services

• 3 locally trained OTs in Central Province covering 2 day services

• Lack of clinical/managerial support/links to other OTs

• Space/income- reliance on income generatingprojects• Limited allied health professionals providing

psychosocial interventions

Volunteer actions/outcomes• Formal /informal training goal setting,

groupwork , OT models • Assessment formats/goal

sheets/documentation• Diversifying range of therapeutic activities

more structured groups with outcome measures

• Supporting managerial skills-setting standards Job descriptions/policies and procedures

• Supporting MDT work – community training –consultancy role in rehabilitation services patient services

• Developing links with other services/ promoting role of OT /management structure

• Assisting with project proposals/funding -establishing new day centre with MDT

2. Residential rehabilitation units

• 2 units -adults severe and enduring - clients aiming to stay for approx 6-12months

• Remote settings- previously abandoned hospitals

• Medical officer and untrained staff• Clients from all over the province• Family contact variable

OT actions/outcomes

• Training in concepts of rehabilitation, groupwork skills, developing the training skills of local counterparts-supporting counterparts in delivering the training

• Diversifying the range of therapeutic activities• Use of individualised goals and care planning• Policies around admission and discharge

procedures and criteria, standards of practice, operational policy

• Multi disciplinary case reviews- weekly visits from other staff-enhancing family involvement

• Outcome measures and assessment standardised –non standardised assessments

• Co-ordinating a monthly rehabilitation committee linking up with day services

• Establishing a family support group

3. Community training

• Primary health care workers -mainly involved in child care

• Previous training in basic mental health• Training changed to include child mental health• Focus on training the trainers and providing

training packages• Production of information leaflets and training

booklets

Challenges /Considerations• Hierarchical structure /language

based/challenges for delegation• Political changes –local /national• Adjusting expectations• “Not another public holiday!”/pace of change • Sustainability • Being different • Stigma

What I gained• Role opportunities that I would not have had

in UK• More flexibility- willingness to let things go-

less time pressured• More in-depth understanding of another

culture-consideration of the wider family/community-alternative views to well being

• A broader view of service development and different model /approaches

• Having time to think• Increased clinical confidence and generic skills• And ......