Occupations of users of a Brazilian mental health service during the COVID-19 pandemic

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic and its resulting health measures led to occupational disruption in several contexts of everyday life. This study aimed to investigate the occupations of users of a unique Brazilian mental health service during the pandemic. This qualitative case study utilized semi-structured interviews to examine the lived experiences of 14 individuals (11 male and 3 female) who were users of a Center of Convivência for mental health. The participants were primarily from low-income backgrounds and mostly identified as Black. Two categories emerged from the content analysis: occupations experienced in and through the Center of Convivência and at home. The center was one of the few places attended by users outside home. During the pandemic, users reduced their weekly attendance, choices, and modality for participating in workshops at the center. Also, they presented a home-restricted life before the pandemic, with limited social circulation, access to leisure and work opportunities. Thus, users had few changes in routine during the pandemic, and housework was their main occupation. Although users had no changes in the existing social limitations and occupational deprivation in the home environment, they experienced occupational disruptions in the Center of Convivência during the pandemic.

The coronavirus disease 2019 (COVID-19) pandemic and its resulting health measures m led to occupational disruption in several contexts of everyday life. This study aimed to investigate the occupations of users of a unique Brazilian mental health service during the pandemic. This qualitative case study utilized semi-structured interviews to examine the lived experiences of 14 individuals (11 male and 3 female) who were users of a Center of Convivência for mental health. The participants were primarily from low-income backgrounds and mostly identified as Black. Two categories emerged from the content analysis: occupations experienced in and through the Center of Convivência and at home. The center was one of the few places attended by users outside home. During the pandemic, users reduced their weekly attendance, choices, and modality for participating in workshops at the center. Also, they presented a home-restricted life before the pandemic, with limited social circulation, access to leisure, and work opportunities. Thus, users had few changes in routine during the pandemic, and housework was their main occupation. Although users had no changes in the existing social limitations and occupational deprivation in the home environment, they experienced occupational disruptions in the Center of Convivência during the pandemic.#La pandémie de coronavirus 2019 (COVID-19) et les mesures sanitaires qui en ont découlé ont entraîné des perturbations occupationnelles dans plusieurs contextes de la vie quotidienne. Cette étude visait à examiner les occupations des personnes usagères d'un service de santé mentale brésilien unique en son genre pendant la pandémie. Cette étude de cas qualitative a utilisé des entretiens semi-dirigés pour examiner les expériences vécues par 14 personnes (11 hommes et 3 femmes) qui étaient usagères d'un Centre de Convivência pour la santé mentale. Elles étaient principalement issues de milieux à faibles revenus et s'identifiaient pour la plupart comme noires. Deux catégories ont émergé de l'analyse de contenu : les occupations vécues dans et par le Centre de Convivência et à la maison. Le centre était l'un des rares endroits fréquentés par les personnes usagères en dehors de leur domicile. Pendant la pandémie, celles-ci ont réduit leur présence hebdomadaire, leurs choix et leurs modalités de participation aux ateliers du centre. De plus, elles présentaient une vie restreinte à la maison avant la pandémie, avec une circulation sociale, un accès aux loisirs et des opportunités de travail limitées. Ainsi, les usagères et usagers ont eu peu de changements dans leurs routines pendant la pandémie, et les tâches ménagères constituaient leur principale occupation. Bien que les personnes usagères n'aient pas vécu de changements par rapport aux limitations sociales existantes et de privations occupationnelles au domicile, elles ont connu des perturbations occupationnelles au Centre de Convivência pendant la pandémie.

En varios contextos de la vida cotidiana, la pandemia de la enfermedad causada por coronavirus 2019 (COVID-19) y las consiguientes medidas sanitarias provocaron trastornos ocupacionales. Este estudio se propuso investigar las ocupaciones de los usuarios de un servicio brasileño único de salud mental durante la pandemia. Para el presente estudio de caso cualitativo se utilizaron entrevistas semiestructuradas dirigidas a examinar las vivencias de 14 individuos (11 hombres y tres mujeres) usuarios de un centro de convivencia para la salud mental. Los participantes procedían principalmente de entornos de bajos ingresos y en su mayoría se identificaban como negros. Del análisis de contenido surgieron dos categorías: ocupaciones experimentadas en y a través del centro de convivencia y en el hogar. El centro es uno de los pocos lugares fuera de casa a los que acuden los usuarios. Durante la pandemia, los usuarios redujeron su asistencia semanal, como también sus opciones y la modalidad de su participación en los talleres del centro. Además, antes de la pandemia tenían una vida restringida al hogar, con circulación social, acceso al ocio y oportunidades de trabajo limitados. Esto significa que los usuarios experimentaron pocos cambios en su rutina durante la pandemia, siendo las tareas domésticas su ocupación principal. Aunque los participantes no sufrieron cambios en las limitaciones sociales y la privación ocupacional existentes en el entorno doméstico durante la pandemia, experimentaron alteraciones ocupacionales en el Centro de Convivencia.

2019 年新冠病毒 (COVID-19) 疫情及其引发的健康措施导致日常生活中的多种生活活动受到干扰。 这项研究旨在调查大流行期间巴西独特的心理健康服务使用者的生活活动。 这项定性案例研究采用半结构化访谈来调查 14 名 Convivência 心理健康中心使用者（11 名男性和 3 名女性）的生活经历。 参与者主要来自低收入背景，并且大多数确定为黑人。 内容分析得出了两个类别：在 Convivência 中心经历过的生活活动和在家里经历过的生活活动。 该中心是少数几个由户外使用者光顾的地方之一。 疫情期间，使用者减少了每周参加该中心活动的出席率、选择和方式。 此外，他们还表现出疫情前的居家生活，社交、休闲和工作机会都受到限制。 因此，疫情期间使用者的生活习惯变化不大，家务劳动是他们的主要活动。 虽然使用者在家庭环境中现有的社会限制和生活活动剥夺方面没有发生变化，但在大流行期间他们还是在 Convivência 中心经历了生活活动中断。

KEYWORDS:

• Occupational science
• everyday life
• occupational engagement
• mental health services
• COVID-19

MOTS CLÉS:

• Science de l'occupation
• vie quotidienne
• engagement occupationnel
• services de santé mentale
• COVID-19

Acknowledgements

We thank the Graduate Program in Occupation Studies for providing specific training to investigate the relations between people and occupations in different contexts. We thank Dr. Ricardo Correia and Dr. Rodolfo Morrison for being part of the Examination Board and offering thoughtful and inspired revisions to the first version of this manuscript. We also thank Marta, manager of the Centro de Convivência, for her partnership during the study, and each participant for sharing their daily experiences, thoughts, and feelings.

Translation Disclosure

This article was translated into Portuguese from English by Leonardo Planel Lugarinho e Sheila Paula da Silva Ferreira, Brazilian professional translators, in consultation with the authors and Dr. Lilian Magalhães, JOS Associate Editor, after completion of review, revision, and acceptance for publication in the Journal of Occupational Science. It is also available in Portuguese from https://www.tandfonline.com/journals/rocc20

Disclosure Statement

No potential conflict of interest was reported by the author(s).