Woman with a spinal cord injury finds a new wheelchair and the confidence to drive again

Ramya, 30, is a busy accountant with a successful career. Ramya became paraplegic after a car accident and uses a wheelchair. She has a full life, enjoying theatre, cooking, and spending time with friends. Since her spinal cord injury six years ago, she has been living on her own in an accessible apartment.

When Ramya’s wheelchair needed to be replaced, she asked her OT to suggest a new model. First, Ramya’s Family Health Team OT did a wheelchair assessment. The OT talked to Ramya to about her physical and lifestyle needs and took measurements. As an Assistive Devices Program (ADP) Authorizer, the OT even completed the forms for Ramya’s application for funding.

The OT also considered how Ramya was managing at work, at home, and in other areas of her life. While Ramya was very independent and happy, she complained about spending so much time travelling to and from places. Because she didn’t drive, waiting for the public transportation system for persons with disabilities took extra time out of her busy day. She wanted to drive again but felt anxious about getting into a car after her accident.

The OT suggested a driver rehab program where Ramya could learn to drive with hand controls. In this program, OTs and driving instructors work together with the client to regain the skill of driving with safe in-car sessions. In choosing a wheelchair for Ramya, they considered one that she could easily lift into the car on her own.

Several weeks later when the new wheelchair arrived, Ramya surprised her OT with an announcement that she booked a driver rehabilitation assessment. With her fast new wheelchair and a plan to get back behind the wheel, Ramya is excited that she will soon be able to get around more easily and have more time in her day.

Promoting the employment rights of people with mental illness in the community

In northeastern Ontario, an occupational therapy research study looked at how accessible employment was for individuals with serious mental illness. The study found that northern communities lacked employment services, and this affected employment rates in the area. The OT study also found that low employment among people with mental illness was a result of lack of best employment practices for this group and not enough understanding about the abilities of people with mental illness.

The OT leading the study learned through a series of interviews and Town Hall forums that community-wide strategies were likely to be more effective than individual efforts in helping people with mental illness find and maintain employment.

The OT invited key people from the community and the region to take part in an employment advisory committee. The purpose of this advisory was to provide supported employment services to remote and rural areas, to educate on employment practices for people with mental illness, and to provide an ongoing network for sharing knowledge.

The group also applied to the Ontario Disability Support Program for a special project grant and hosted a conference, called Without Labels, on promoting the employment rights of people in northeastern Ontario with mental illness. This conference welcomed over 100 participants from throughout the northeast and provided a place to share knowledge, network, and work on next steps.

This community development project has led to a better understanding of the abilities of people with mental illness, and effective employment strategies for this group.

The project also brought together key partners from health, social services, and municipal sectors, who look at ways to ensure that funded employment policies and programs are helpful to people with mental illness. Their ongoing efforts have improved employment rates in the region.

Troubled preteen transformed by early occupational therapy intervention

Jesse was a 12-year-old boy with a history of hospitalizations for mood and behavioural problems including threats to harm himself and others. He was suspended from school many times because of aggressive behaviour and stopped going to school altogether. He committed chargeable offences and was at high risk of entering the justice system. He made allegations of familial abuse, felt unloved and unwanted by family and peers and had low self-esteem.

Jesse was highly resistant to therapy or interventions of any kind but was very keen to take part in work-based sessions with an occupational therapist. Given his age, the idea of having a job was very appealing and made him feel very mature. The opportunity to do something that gave him independence, responsibility and respect was what he needed to move on with his life.

As a result of work-based therapy, he learned to follow rules, take care of his appearance, communicate appropriately, be responsible, get along with others, and put forward his best effort. Because he realized that he had skills and abilities and could control his life in a positive way, his self-esteem grew. Jesse went into his teen years with a thirst for independence and productivity instead of becoming a statistic in the justice and health systems.

Occupational therapists are trained to use age-appropriate and meaningful treatment interventions. Jesse’s occupational therapist realized that talk-based mental health approaches were not effective for Jesse because they were not engaging or meaningful to him.

Jesse’s involvement in the kind of therapy that best suited him was a transforming experience. From his and his family’s perspectives, OT helped lead him down a healthier future path rather than one leading to jail and serious mental health issues.