title: Living in a glasshouse: exploring occupational alienation.
abstract: BACKGROUND
  Community mental health care has shifted focus from resettlement to empowerment, reflecting a wider agenda for social inclusion.
  
  
  OBJECTIVE
  This study evaluated mental health day services from the perspectives of thirty-nine clients.
  
  
  METHODS
  Data analysis of the four focus groups explored the implications for occupational therapy. The data collected were subjected to constant comparative analysis and theoretical sampling.
  
  
  RESULTS
  Participants described how mental health day services structured their day and enabled access to support networks. However, many perceived aspects of the services as fostering their dependence and threatening sessions they valued. This dependency led to them feeling alienated and wishing to seek greater influence over decisions about their current and future life. The concept of occupational alienation was used to further interpret their situation.
  
  
  CONCLUSIONS
  Occupational therapy could overcome occupational alienation experienced by mental health day service clients, through the development of services within and beyond day services which promote a sense of belonging and offers meaningful occupation.
authors.affiliation: Brunel University, School of Health Sciences and Social Care, Isleworth, Middlesex, UK. wendy.bryant@brunel.ac.uk
authors.forename: Wendy
authors.initials: W
authors.lastname: Bryant
authors.forename: Christine
authors.initials: C
authors.lastname: Craik
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: McKay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003156:Community Mental Health Services; D019058:Community Networks; D003631:Day Care, Medical; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000534:rehabilitation; D008875:Middle Aged; D009788:Occupational Therapy; D010358:Patient Participation; D011369:Professional-Patient Relations; D012931:Social Environment; D012944:Social Support