Structural Relationships Among Positive Occupations, Psychological Distress, Life Functioning, and Well-Being in Community Mental Health

This cross-sectional study examined associations among positive occupations, psychological distress, life functioning, subjective well-being, and perceived interpersonal difficulties among 276 adults with mental illness receiving community-based mental health services, including psychiatric day hospitals, in Japan. Positive occupations were defined as occupational experiences characterized by personally meaningful engagement, a sense of involvement, opportunities for achievement, and supportive social interaction. Structural equation modeling showed acceptable fit (comparative fit index [CFI] = 0.927, Tucker–Lewis index [TLI] = 0.922, root mean square error of approximation [RMSEA] = 0.062, standardized root mean square residual [SRMR] = 0.066). Greater engagement in positive occupations was associated with lower psychological distress (β = −.560), higher life functioning (β = .633), and higher subjective well-being (β = .297). Psychological distress (β = −.369) and life functioning (β = .211) were also associated with subjective well-being, which was associated with fewer perceived interpersonal difficulties (β = −.430). Findings are consistent with considering positive occupational engagement in recovery-oriented occupational therapy for community mental health.