One of the main reasons why it has become necessary to look in more detail at the role of occupational therapists in mental health care is the changing role of health care professionals in general which has taken place in the past decades and which has led to a re-structuring of the health care industry as a whole. As Thorner (1991) and Lloyd et al (1998) have pointed out, there have been significant changes in the way that health care is structured, in terms of the welfare versus the consumer model, and as a result there is an increasing emphasis on community-based care initiatives and the autonomy of the health care recipient. Consequently, professionals in various fields of mental health care are re-evaluating their roles, both in terms of their own professional competence in relation to others in the same field and with reference to their interaction with their patients.
Greaves et al (2002) make the point that the move towards community initiatives has tended to erode the earlier bureaucratic model of institutionalized health care, which in turn has meant that community based workers have a higher profile in the field as a whole, and are having to develop a greater degree of autonomy. The competence of mental health workers, and the way in which they perceive themselves, has therefore come under greater scrutiny.
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