Support therapy for children overloaded
The only occupational therapist at the Mid-Atlantic Wellness Institute’s child and adolescent services department is dealing with more than double the expected cases.
Moffat Makomo, who specialises in treating children with mental health challenges, said more therapists were needed to help to deal with cases that are also becoming more complex and time-consuming.
He said: “My caseload is almost 74 children but you’d find the challenges with that is the caseload is actually way too big for what’s expected.
“Typically for my role, it should be 30 cases but because of challenges with resources, you’d find we have those huge caseloads.
“So what we tend to do is now look at what the efficient ways are of us providing services to our population.”
He said this could involve group work and educating the community and caregivers about behaviour patterns and suitable activities, “which will help them manage them and need less professional input”.
Mr Makomo also pointed out that cases were “getting complex as well”.
He said: “We are seeing more and more of those cases where it’s not just the child who needs services but it can be the whole family.
“I might be seeing a child whom we are suspecting has ADHD [attention deficit hyperactive disorder] and possibly also has Autism Spectrum Disorder but they are also coming from a dysfunctional household as well.”
He said the child might also have been forced into a group or gang or an attempt made to force them.
Mr Makomo: “So it’s now looking at both social aspects of it, looking at family pieces of it, as well as looking intently into the child’s challenges with coping as well.
“Because of that, it would mean besides you seeing the child one-on-one, we are also making telephone calls to different agencies and trying to collaborate with them, trying to have team meetings to also look at how efficiently and effectively you can provide services, not for that child only but also for their family and everyone involved.”
He said complicated cases could be down to various factors, including the home environment.
Mr Makomo added: “It could be because the child is in foster placement. It can be because of environmental factors, it can be because of their own biological make-up, whereby they have challenges interacting with others. And for some children, it might be genetic. Sometimes you only need certain triggers to exacerbate the symptoms.”
But he said that this had also led to an increase in the amount of time spent on each case.
“I definitely see how there is now more administrative work, more telephone calls, more team meetings for a particular case than used to be.”
Mr Makomo, who has worked at Child and Adolescent Services since 2009, helps children and young adults find activities and ways to cope with daily tasks in a bid to build their self-esteem and social skills. As the only occupational therapist at CAS, he is part of a multidisciplinary team that consists of a family therapist, social worker, psychiatrists and psychologists.
Mr Makomo said that CAS would “definitely” benefit from more occupational therapists.
But he added that also applied to other healthcare areas in Bermuda because occupational therapists work with people of all ages.
Colleague Morrisa Rogers, of the Bermuda Occupational Therapy Association, agreed that more occupational therapists “would be beneficial”.
She said there were currently 35 registered occupational therapists in Bermuda, including eight specialists in the care of children.
But Ms Rogers added: “Unfortunately the current private reimbursement structure makes it difficult for therapist in the community to establish sustainable practices.”
As well as working in private practice, occupational therapists on the island are employed by Bermuda Hospitals Board and the Department of Health.
Health minister Kim Wilson highlighted the work of OTs to mark World Occupational Therapy Day last Friday.
Ms Wilson said: “Every healthcare team would want to have an OT. They help people with various illnesses and disabilities adapt to their circumstances.
“The Ministry of Health recognises the increasing need for occupational therapists, and it is one of the areas of study that qualifies for our Barbara Ball Health Scholarships.
“Occupational therapy is a very rewarding career for those who would like to help people living with Alzheimer’s disease, cerebral palsy, autism or the loss of a limb, for example, while working as part of a team.”
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