The OT Shift: Physical Health to Mental Health

Those of you who follow my twitter will know I have recently switched from being in a physical health rotational post, to a post in community mental health (CMHT). Here’s a little journal on how the change is going so far!

How fast does time go? Half way through my induction, and what a 2 weeks it has been! Overall, so far so good! I have met what feels like 100’s of different people and it has been hard to keep up with names and job roles. But I have managed so far, to not let my anxiety win. I’ve had to shadow numerous different people, and I’ve tried so hard not to be my quiet awkward self (or that's how I feel I'm perceived), and do you know what, it has paid off. I am so proud of me. It’s so nice to see your own personal growth. I’m at a place I never thought I would ever get to, and here I am. Don’t get me wrong, there has still been days where my anxiety has been triggered, but all in all I’m managing these feelings so much better than the old me would. And now I’m in a job role where I can support others to do the same, overcome the challenges that come with anxiety (and other mental health difficulties), and learn healthier coping strategies. I could burst with excitement, and pride.

Why did I decide to switch from working in physical health to mental health? Well as you guys have probably gathered from my blog, mental health is where my passion lies. I’ve always had an interest in working in mental health, but I feel I definitely needed to get ahold of my own struggles, before I could fully help others. Physical health OT was a great experience too, I’ve learnt heaps there, and those skills I can definitely transfer into my practice within mental health services. But when work was tough, it was hard to stay motivated when my passion wasn’t there. I wanted to be able to use my passion and skills, to progress in my career and provide better quality therapy to my service users. And I felt like the time had come for me to this.

Leaving the physical health setting was not an

easy decision though. I had only been there for around 6 or 7 months when I handed in my notice. I felt embarrassed because I had not been working there for very long. Battling with thoughts of whether I should give it more time, and questioning what people would think. But ultimately I was not happy there, and I had to put my happiness and interests first. Don’t feel like you have to stay somewhere because it’s what you feel others expect of you. Follow your heart, take the leap of faith. A lot of things in life are trial and error, and if something doesn’t work out, it’s not a failure, it’s a learning experience. I would rather feel like “at least I tried it” than “what if”.

It’s hard as a newly qualified to know what direction to go in. Some people know for definite what specialism they want to work in when they finish uni, but a lot of us don’t, and that is OK. We only get 3 placements, and in the OT world that’s barely even dipping your toe into the breadths of direction you can take with your degree. It can be so overwhelming. I went for a physical health rotational post because I felt it was the “norm”. But sometimes you have to follow your gut and do the unexpected. Throughout my time at uni, I always quite openly said I never saw myself working in a hospital setting. Maybe I should have stuck to my guns. But also I don’t regret taking that job, everything happens for reason and I learnt a lot about myself and what OT looks like in physical health setting.

What has the change been like so far?

Extremely different! That’s part of the beauty of OT, it varies so much depending on the setting. I’m usually someone who struggles with change, but actually this change has been so positive for me so far. Maybe because I’m not putting pressure on myself to know everything and be perfect like I usually do! In all honesty, I have no idea when this changed for me, but it’s beautiful to see!

• First of all, it’s office based. I have never worked in an office before, it feels very weird! But it’s so much more relaxed than trying to do work in a little room amongst a busy ward. It’s a lovely environment to be in with your fellow colleagues when they’re in. It feels more informal.

• You have more control of your diary. Hospital environments can be more structured. CMHT is still somewhat structured, you have set meetings/MDTs at specific times etc. but you work closely with your patients to schedule visits etc. that suits the both of you. I feel like this is really nice! We love collaborative working with our patients!! It’s also great if you’re a well organised person.

• However it is more lone working. Majority of the time you’re going to visits on your own. BUT there are so many opportunities to liaise with and reach out to your colleagues and so many people you can speak to for guidance and support. I feel as though I may have struggled with this when I first qualified, but this is definitely a personal thing. The hospital environment although you may be seeing patients on your own, there is always people physically around to support you or ask questions too right there and then if needs be, which is a great safety blanket.

The OT service is in high demand in both sectors, the pressures are there in both, but it feels different, although it is relatively similar. I guess in CMHT, prioritisation is heavily related to risk, so it feels like slightly more pressure to make the right call because you have to think about whether the patients are a risk to themselves or others, or what the impact would be if they further declined, including the impact on ADL participation. If they’re at home or don’t have a good support network or access to self-help resources, they’re dealing with these deliberating things on their own. The hospital setting is about bed demand as well as the risk of patients deconditioning mentally and physically - and the impacts of this on the patient and discharge planning. However, there’s staff there 24/7 to “observe” them and their safety. But there is still the pressure and risk of how they will cope on discharge if the deconditioning has had an impact on ADL participation.

All in all, some will prefer physical health OT, and some will prefer mental health. It’s a personal journey. I enjoy elements of both, but the area I see myself thriving and developing in is mental health. There’s pro and cons to both, so have to think about what is right for you. If you are debating between the two, reflect on placements, how did you feel on them, what were you most interested in, where do you see yourself within your career in the next 3 years. I think I always mentally envisioned myself in mental health when I would think about where I wanted to be in the future and where I felt I could make the biggest difference. What does it look like for you? Remember there’s no pressure to be 100% sure. You’re interests my span across the two, or you might just straight up not know! The only way to know is try different things, and if you try one and it doesn’t work out, that’s okay!! Onwards and upwards always, and there is always something you can take away with you to bring into your new role!

Speaking to other OTs you know and networking on twitter or other platforms is a great way to find out about different roles and it looks on a day-to-day!

Have your say on my next blog post!

• Perfectionism and performance anxiety.
• The struggles of being an introvert.