Exploring the Development of Self-Efficacy to Impact Discharge Preparedness in Major Depressive Disorder After Engaging in an Occupational Therapy Interactive Group Model Intervention

Abstract

Introduction: This study explored the development of self-efficacy and discharge preparedness in Mental Health Care Users (MHCUs) diagnosed with Major Depressive Disorder (MDD) after participating in a closed Occupational Therapy Interactive Group Model (OTIGM) group intervention over four days at a private, acute psychiatric hospital in South Africa. Given the limited post-discharge support, enhancing self-efficacy is vital for transitioning home to promote long-term recovery and potentially reducing readmissions. Method: A convergent mixed methods design was used to explore change in self-efficacy and discharge preparedness following participation in OTIGM intervention. The quantitative strand (n=78) employed a longitudinal approach, to identify change in pre- and post-test scores from the Mental Health Self-Efficacy Scale (MHSES) and discharge preparedness ratings. The qualitative strand (n=10) utilised semi-structured interviews, analysed using directed content analysis, exploring the perception of the influence of OTIGM intervention on self-efficacy to impact discharge preparedness, how the OTIGM intervention fostered self-efficacy and influenced perceptions of discharge readiness. Results: The findings revealed a positive correlation between improved MHSES scores and increased discharge preparedness. Qualitative findings highlighted the development of all four sources of self-efficacy (mastery, affective states, vicarious experience and verbal persuasion). Additionally, evidence of self-agency and the positive impact of the hospital environment was found. The research identified ambivalence towards discharge, reflecting both hope and hesitancy about transitioning to the home environment. Conclusion: This study provides evidence that OTIGM enhances self- efficacy and discharge preparedness in MHCUs with MDD. Underscoring the value of closed-group occupational therapy in fostering self-agency, promoting mental health self- management, and supporting community reintegration after acute psychiatric admission.