Institutional injustices? Exploring engagement in occupations in a residential mental health facility

Residents of mental health facilities may be at risk of occupational injustices if their participation is restricted. A case study approach was adopted to explore the experience of engaging in meaningful occupations in residential facilities and the occupational injustices that occur when participation is restricted from the perspectives of residents, their family members, and staff members. Semi-structured interviews were conducted with residents, staff, and family members from one residential facility. Using an inductive approach to thematic analysis, four themes relating to occupational injustices emerged. Residents experienced restrictions to engagement in activities of daily living, few opportunities for purposeful occupations, a lack of productive roles, and institutional rules and practices contributing to a restrictive setting with limited occupational choice and autonomy. The findings emphasize the need for a redistribution of power from staff to residents to facilitate greater participation to achieve occupational justice in residential facilities. Policies and procedures that empower and promote inclusion, along with care practices that promote autonomy, are essential for power rebalance. Both management and staff of residential facilities and the wider multi-disciplinary team are crucial to the actualization of occupational justice.