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How tāngata whai i te ora | Service Users Experience Their Occupations During COVID-19 Restrictions in a Forensic Mental Health Setting: An Interpretive Description Study

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Jones, Margaret
McKenna, Brian

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Master of Health Science

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Auckland University of Technology

Abstract

Background: Within forensic mental health settings, tāngata whai i te ora | service users are at risk of occupational deprivation that can detrimentally impact their rehabilitation, recovery, and well-being. The COVID-19 pandemic exacerbated these concerns with the implementation of Public Health and Safety Measures such as social distancing; isolation requirements; and closure of workplaces, learning centres, and community businesses, such as gyms and cafes. Methods: A qualitative interpretative descriptive study was undertaken to explore tāngata whai i te ora | service users’ experiences of their occupations during COVID-19 restrictions, while living in a forensic mental health service. Once ethics approval was obtained, seven tāngata whai i te ora | service users, residing in three minimum-secure units, were recruited via purposive sampling. Data were collected through individual, semi-structured interviews. Transcribed data were then analysed using reflexive thematic analysis. Findings: I interpreted four themes from the data. These were: 1) ‘COVID Came Along and Pulled the Carpet’, which described the sudden, unexpected disruption experienced by tāngata whai i te ora | service users to their everyday occupations, and the way this disruption led to experiences of loss and frustration; 2) ‘The Layers Upon Layers of Restrictions’, described the multiple layers of restrictions experienced by tāngata whai i te ora | service users that created barriers to everyday activities; 3) ‘Keeping the Vibes Going on the Unit’, included the intuitive attempts of tāngata whai i te ora | service users to create connections that improved occupational participation and well-being, and; 4) ‘A Learning Experience’, illustrated how tāngata whai i te ora | service users used previous experiences and new learnings to provide them with coping strategies to guide them through the restrictions. Implications: The findings demonstrate the opportunities for co-production of policies, education, and communication strategies during emergency events. These processes can strengthen roles, and the sense of belonging and connectedness that contributes to secure recovery for tāngata whai i te ora | service users. The results also highlight the inequalities forensic tāngata whai i te ora | service users face, and the need for services to implement holistic, culturally responsive support. Equally significant were the range of supportive and enabling factors that occurred to enhance occupational participation and well-being during unprecedented times. Information from the study will be used to identify areas for improvement in forensic mental health services responses to COVID-19 (and to other pandemics or emergency events), and to enable occupational participation and prevent experiences of occupational injustice.

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