Time-Use and Mental Health in Older Adults: A Scoping Review

Contributions of a time use perspective in community mental health practice: a scoping review

Introduction

Time use is an important indicator of health and well-being. Exploration of time use can provide in-depth information about individuals' activity patterns including routines and structure, the experience of activities, personal priorities and challenges. People experiencing severe mental illness may be at particular risk for time use patterns associated with poor health and wellbeing.

Methods

This scoping review aimed to identify and map the evidence about how a time use perspective informs assessment and intervention in community mental health practice. Electronic databases and hand-searches were used to identify relevant studies involving people with severe mental illness, and focused on time use applications in practice. Twenty-nine studies were included in this review, data-extracted and synthesized with reference to the review question.

Results

Of the twenty-nine identified studies, seven described development and psychometric testing of time use assessments; twelve used time use tools to measure outcomes; and ten described or evaluated time use intervention approaches. The identified time use assessments typically involved retrospective diaries completed before or during structured interviews, and an Experience Sampling Method using smart technology to gather activity data in real time. Both psychosocial and occupational interventions used time use to measure outcomes relevant to activity engagement, social functioning, and personal recovery. The identified time use interventions originated in occupational therapy; included structured manuals and workbooks to enable reflection on daily time use; individual or group sessions to collaborate in identifying priorities, goal planning and supporting desired changes to activity patterns. These interventions were viewed favorably overall, with improved activity engagement, quality of life, and personal recovery reported.

Discussion

Time use assessments evaluate outcomes of importance to personal recovery and community inclusion. Time use interventions address activity patterns associated with poor health and wellbeing, using collaborative and supported activity engagement approaches, and contribute to emerging evidence on interventions that support personal recovery. Furthering peer involvement in developing and delivering these interventions will bring important insights to time use practice and research, while the social forces that marginalize or constrain activity participation for people with severe mental illness also need to be addressed to advance time use and other approaches that aim to support community inclusion.

"You Need to Set a Daily Schedule": Understanding Successful Aging via Three-Sided Viewpoints

This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults' family members, and health professionals) and 18 interviews with older adults (older adults Mage = 71.7 years, Standard Deviation = 4.62). The transcripts were analyzed using constructivist grounded theory principles. Three categories were identified for successful aging: (a) engagement with life, including social participation, fixed/flexible schedule, time, and meaningful occupation; (b) self-management abilities, including producing daily schedules, independence, and initiation/striving toward goals; and (c) diversity among older adults, including their views on retirement, being active or not, and their dreams/values/goals. Considering the diverse nature of older adults, recognizing the importance of life engagement and self-management abilities emphasizes the necessity for an occupation-based, self-tailored approach to enable successful aging.