The effects of a therapeutic recreation intervention on community based consumers of a mental health service in regional Australia

Over two decades ago, the deinstitutionalisation process began in Australia with the intent of moving consumers of mental health services from inpatient facilities into the community. This has been, and continues to be today, a challenge for people with mental illness, as well as members of their social support network and service providers alike. Importantly, this on-going transition has highlighted the fact that consumer needs have remained largely unfulfilled throughout this process. One unmet need has been the lack of provision of appropriate leisure services for people with a mental illness. Historically, leisure services have suffered from a lack of recognition by various state mental health services. Dowla (1997) and Cassidy (1996) have strongly argued that there is a need for further empirical research to be undertaken to explore the proposition that leisure is a positive aspect of an individual's health and well-being and that leisure services should be an important element of mental health service provision. The main purpose of the study was to explore the relationship between leisure participation and the health and well-being of community-based consumers of a regional mental health service. The sample population consisted of 46 community based consumers of the Rockhampton District Mental Health Service (RDMHS), aged 18 years or older who were living in the Capricornia region of the State of Queensland. Of those that completed the study, 35 (76.1%) were men and 11 (23.9%) women. A large percentage (65.2%) of the research participants were diagnosed with schizophrenia, while the remaining participants were diagnosed with depression (21.7%), anxiety (8.7%) or other medically diagnosed mental illnesses (4.3%). Subject ages ranged from 18 to 58 years, with a mean age of 38.9 years. The study undertook a quasi-experimental design using a pretest, post-test and 6 month follow-up procedure to examine the variables of perceived control, life satisfaction, self-efficacy and intrinsic motivation. The unit of assignment was three groups that included two intervention groups that used different leadership styles (autocratic and democratic), and a comparison group. The therapeutic recreation intervention was undertaken for a three-hour duration, once a week for a period of 24 weeks. Analysis took the form of a repeated measures Analysis of Variance (ANOVA) with additional qualitative analysis of data using focal group interviews that were undertaken at the completion of the study. Significant differences were found between the groups on the variable of perceived control for the period of the intervention. A substantial increase in the levels of life satisfaction, intrinsic motivation and self-efficacy was also found for the intervention groups, with the qualitative data analysis reinforcing the importance of perceived control and enjoyment as key factors in program planning. Results of the study also found that a strong correlation between life satisfaction and intrinsic motivation (r = .52, p The findings of this study support the importance of employing leisure therapy staff in case management teams who are cognisant of the need to establish a positive environment that is designed to facilitate the empowerment and quality of life of mental health consumers. Furthermore, the research findings provide additional support to validate the importance of leisure programs in community-based psychiatric facilities with disadvantaged populations. Therefore, it is important that health care professionals who implement leisure programs to improve the quality of life of mental health consumers are aware of the need to address associated problems such as lack of motivation, poor self-esteem and social disconnectedness. This can be achieved by providing opportunities to allow people to have greater control over their lives through a variety of leisure experiences that support positive feelings of self-efficacy, intrinsic motivation and life satisfaction.