OT & Michelle: Early Identification and Intervention for an Adolescent with a Serious Mental Illness

Michelle was a 16 year old girl being assessed in a residential mental health facility as a result of escalating behavioural issues including aggression, falling grades, and substance abuse. She was diagnosed as having a Conduct Disorder at the age of 12 and has a history in the justice system. Discharge plans were complicated by the fact that her foster family was not willing to take her, she preferred to live independently, and she was of an age to make such decisions on her own. She had been taking part in occupational therapy assessments related to independent living and cognitive capacity. She had refused to take part in formal or standardized assessments, therefore the occupational therapist utilized leisure-based and work-based sessions with which Michelle was more comfortable. During the sessions, there was gathering evidence that Michelle may have been in the early stages of developing a psychotic disorder. This was later confirmed by a psychiatrist where she was eventually diagnosed with schizophrenia.

The occupational therapist was able to assist Michelle through the process of gaining an understanding and acceptance of her illness. The occupational therapist was also instrumental in helping Michelle to prepare for her transition as a young adult to the community to live as independently as possible, and to explore appropriate school programs, volunteer and paid work, and leisure occupations to create balanced daily routines. Michelle was able to make decisions about her school and work goals that were more realistic and learned that taking care of herself, such as addressing her addictions issue, was important in managing her illness.