Exploring consumer functioning in High Dependency Units and Psychiatric Intensive Care Units: Implications for mental health occupational therapy.

BACKGROUND/AIM: Consumers admitted to High Dependency Units (HDUs) or Psychiatric Intensive Care Units (PICUs) experience very significant functional difficulties. These can make it challenging to deliver targeted occupational therapy interventions. This study was established to analyse previously collected data to better understand consumer functioning in HDUs and PICUs.

METHOD: The Hyperacute Screening Tool (HST) includes descriptors of increasing functional skills in three domains of functioning (task performance, social performance and task initiation). Data were extracted from 360 HSTs from 70 individuals admitted to a male HDU and a PICU in a mental health facility in metropolitan Sydney and analysed using the Rasch analysis program Facets.

RESULTS: The hierarchy of category descriptors in each domain of the HST was correctly ordered, suggesting that the pattern of regaining functional abilities in the HST is accurate. Results suggested that there may be some conceptual overlap between adjacent categories and that the pattern of regaining functional abilities as described in the HST may not be applicable to a minority of individuals.

CONCLUSIONS: This study provides the first description of functional abilities of consumers admitted to an HDU and PICU. Results were used to develop an initial conceptualisation of 'stages' of regaining functional abilities and a set of initial guidelines to support targeted occupational therapy interventions. This study will contribute to a better understanding of the functional abilities of individuals admitted to HDUs and PICUs and will support the development of optimal occupational therapy interventions in these settings.