Leah Bisignani

Journal 2 – Harding Hospital

The majority of the patients seen thus far have had sever Major Depressive Disorder,

Bipolar Disorder, and Schizophrenia. Although more rare, I have also seen a few patients with

auditory hallucinations. In addition to these diagnosis, many patients have been struggling with

substance abuse of some kind (including alcohol, tobacco, crack, and cocaine).

I have not seen any standardized or commonly used assessment performed. However,

when I asked, my fieldwork educator stated that the SLUMS and ACLS are frequently used. The

majority of the assessment occurs throughout the occupational profile with the patient –

building rapport and learning what is meaningful to them and how certain coping skills can be

implemented. We also are very vigilant as to what types of resources would be helpful for each

patient. Some common resources provided are daily self-care checklists, tools to help with med.

Management, self-evaluation tools, and goal setting activities (whether that is daily or long-

term). Patients have also been provided with positive affirmations, comforting bible verses,

reading suggestions, Ted Talks and other YouTube references, Chair yoga, journal topics, 234

things to do in Columbus, and 44 ways to volunteer in Columbus.

Many of the psychosocial challenges with these clients are their current living and

familial situations. Unfortunately, the majority of the patients we have been working with this

week do not have a safe and stable home environment. A lot of them do not even have strong

social support. Therefore, it is difficult for them to consider their plans after being discharged.

Additionally, a lot of the patients are not able to take care of their own children, which is a huge

stressor for them. Lastly, as previously mentioned, there are many patients who struggle with

substance abuse – which has really opened my eyes to the lifestyle of those victims and how
powerful drugs can be. Most of the functional challenges that I have observed at Harding have

been related to MDD – not being able to get out of bed, lacking in simple hygiene, and making

the smallest of tasks very difficult. I also have noticed that no matter the diagnoses a large

amount of patients who have the same negative coping skills – such as bottling things up,

isolating themselves, suicidal ideation, self-injurious behaviors, and substance abuse.

I also have been very surprised with how many patients feel that the reason they are in

this position is due to a lack of working medications or some other kind of fall through with

another medical profession. One patient stated that the pharmacy would not get back to him,

while another older lady stated that the nursing home did not pick up on signs of her

encephalopathy resulting in extremely poor physical and mental health, and yet one more

patient stated that her last hospital trip resulted in her contracting MRSA.

Overall, from what I have been observing this week, OT plays a very similar role to

psychiatrists and psych related professions in this setting. However, OT really focuses on being

client-centered, individualistic, helping patients find what is meaningful to them, and also

adding the functional component into mental health illness. We spend a majority of our time

just therapeutically talking to patients and helping them process their conditions, seeing what

areas of functioning need improvement.