“Engagement in meaningful activities is significantly correlated with satisfaction with life as a whole ” – Goldberg & Britnell (2008)
The quote above highlights how important taking part in meaningful activities are in order to improve our wellbeing. For example we have jobs or hobbies; whether it is exercise or music, sports or cooking these may all be things that are meaningful and can improve our well being and mental health.
Generally (not everyone) people who experience mental health problems may lose interest in meaningful activities, have a dysfunctional relationship with activities or have none particularly if they are relapsing or experiencing mental health issues for the first time.
Service users may be admitted to hospital if they find it difficult to plan and organize daily life this could be due to hearing voices which can affect the ability to communicate with other people, may be being exploited or abused, harmfully using alcohol or drugs or behave in ways which may appear threatening resulting in contact with police. Medication may also not be working, or have stopped taking the medication, may be experiencing suicidal thoughts or struggling to manage with every day activities.
The role of an activity coordinator on a mental health ward aims to encourage, motivate, maintain, teach and develop meaningful activities and support recovery for each person who comes into the ward. This may sound like a huge responsibility, but it is not all of yours you are part of a team of multidisciplinary professionals who aim to provide this; however your role is a huge contribution. You may learn, as I learnt that you are seen and treated entirely different by the service users compared to doctors, nurses or even healthcare assistants (hca) in most cases. However this will also depend on your personality and attitude.
From my experience and knowledge medical staff are treated more negatively than non medical staff as they are medically treating the person and if a service user does not want to be treated with medications, medical staff often experience the frustration from service users. It is an incredibly challenging job and I’ve a hella lot of respect for the medical teams. By developing positive relationships with service users you will help aid magnificently in their treatment plans and recovery outcomes.
To work on a psychiatric ward as an activity coordinator emotional resilience is key, you should be open minded, responsible, hold a degree of common sense, laidback, fun, honest and trustworthy. These are just a few personality traits which are important to have. I worked on an acute mental health ward, with a huge variety of clients and mental health conditions including; Schizophrenia, Schizoaffective disorder, depression, anxiety, psychosis, bi polar, bi polar affective disorder, unspecified organic psychosis, personality disorders (emotionally unstable, antisocial, narcissistic) and learning disability patients who fall through the gap… it is important to brush up your knowledge so to some extent you’ll know what to expect.
What do I mean by meaningful activities on a psychiatric ward?
Meaningful activities mean the activity will benefit the service user. I believe and particularly in the National Health Service (NHS) care is patient centred. It is important to involve the service users together or individually in what activities they are interested in or will benefit from.
The Community Meeting: Every week a community meeting should be held to offer the opportunity for service users to present and discuss their ideas regarding the ward in general and activities.
The role of the activity coordinator is to manage this meeting, answer queries, raise queries to team managers, deal with conflicts, reassure positives and assess risk of suggestions. The meeting itself is meaningful as it encourages discussion, group work and social inclusion.
Routine is very important in recovery, although sometimes not everything goes to plan it is important to implement some form of routine into their lives. We wake up, shower, dress, eat breakfast, brush our teeth – some service users may have difficulty with planning and organizing this routine or struggle with self care.
Below is an example of an activity timetable which are displayed colourfully and in large print around the ward:
To pin point a few:
Music Groups: Music is engaging, distracting, communicative, physical, social, affects behaviour (North and Hargreaves 2008), affects identities, improves mood and concentration. There is vast quantities of research in music psychology and therapy showing it as beneficial. Surgeons even play music to relieve anxiety and pain for patients (Heijden 2015) this is pretty generalisable research.
Gather a vast collection of CDs; ask for donations, buy from charity or junk shops as just sitting in a room with a service user listening to music can really engage and help them open up to you. Try drum circles (make or buy Congo drums), provide guitars, access to keyboard, provide a harmonica, recorder or find a volunteer to perform an interactive music session if you aren’t able to yourself. Similarly beneficial are art groups and mindfulness colouring.
Cooking Groups: These are always the most popular groups, as the service user will immediately benefit from taking part in the session plus unknowingly develop useful everyday skills. Smoothie group is a good way to introduce healthy eating, many antipsychotic medications increase appetite and often service users may reach for a take away menu; however having a freezer stashed full of frozen fruits or veggies, can be a good way to encourage a healthier snack to avoid weight gain.
Baking group encourages team work and is a good way to identify their skill level in order to feedback to the Occupational therapy team if they need further assistance at home or not. Suggestions: cookies, chocolate or blueberry muffins, fruit cake, ginger biscuits, flapjacks, lemon drizzle loaf cake… print out and laminate an easy read recipe, keeping instructions simple, break down the tasks so each person has a role.
Sports: Exercise is an active solution, a vast amount of research reports the beneficial effects of exercise it can improve social skills and behaviours, self esteem and attitudes (Bailey 2006). The National Institute of Care and Excellence (NICE) recommends people with moderate depression should take part in 45 minutes of exercise 3 x a week for a minimum of 3 months to see an improvement in mood.
Even if you just go for a walk or jog round the garden, buy a football and have a kick around a few times a week, depending on your budget table tennis is an excellent activity involving team work, hand eye co-ordination, low intensity exercise and suitable for all ages and abilities. If you have the budget buy a Wii Fit or reach out to other wards to see if they have old equipment you can borrow.
Obviously you cannot be there all the time therefore it is important to have low risk available activities such as jigsaw puzzles, board games including scrabble, printed word searches, Sudoku puzzles, daily newspapers, books; language, fact and fiction, printed mindfulness colouring sheets, spare pieces of blank paper and a box of felt tip pens.
Motivating service users is a huge part of the role, motivating some will be easier than others, with others it may take time – do not be disheartened if only 1 – 3 people attend your groups as every week will vary depending on the clients on the ward. If someone finds being in a group difficult, find an activity they enjoy – puzzles – and sit together to do a small task for 30 minutes. A small task is better than no task. They may gradually over time become involved in smaller groups of 2 or 3 people. You may find service users motivate their peers to attend groups or will organize a game of scrabble or football within themselves.
Finally one more key thing to remember is risk. Be aware of risks in activities, have a record of sharp objects; scissors, knives, can openers etc, be aware of using certain materials in art such as long pieces of string, wire, glues, strong smelling paints or hairspray.
Be risk aware of the service users you work with, every service user will have a risk assessment based on risk to self and risk to others – find these out before you work in a one to one setting. If ever worried about risk do not be afraid to ask other staff to support you in a session. If no one is available run the activity in a communal space or somewhere you can be visibly seen by other staff. Finally be aware and incident report violent or sexual behaviours towards staff or other service users.
The role is complex, exciting, interesting and you will learn more than ever about mental health and people. You will develop experience of working in a dynamic team of nurses, doctors, HCA’s and work very closely with Occupational Therapists. It is an educational and creative post and definitely worth giving a go if you want to work in mental health, it is an ideal stepping stone role for a future occupational therapist or psychologist/therapy role.
If you enjoyed this post or have feedback please let me know – this is not completely extensive or completely generalizable but it is a guiding introduction into activity coordinating in a psychiatric ward.