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This practice piece aims to review an occupational therapy led pilot programme – social farming as an intervention option in an adult community mental health setting in Ireland. It will also reflect on the practical implications of delivering the natural surroundings based programme through the COVID-19 pandemic and plans for the future development of such programmes in adult mental health services.

The Occupational Circumstances Assessment Interview Rating Scale (OCAIRS) was used to measure occupational participation (Forsyth, 2005). This was administered with participants’ pre and post their participation in the 10-week programme. An internal questionnaire was developed to further capture both the participant and farmer experiences of the social farming programme.

Whilst improvements were noted in a number of OCAIRS domains, it was difficult to identify small changes over a short period of time. The main domains of change were habits, roles, interests and personal causation. The success of the social farming placements was also reflected in the internal questionnaire. The pilot programme has resulted in the further development of the social farming programme and securing of funding for placements for five years.

It would be beneficial to consider other standardised assessments that assess quality of life and occupation for future placements. It is also beneficial to consider practical implications in delivering a social farming programme, particularly to those with barriers to transport. It is hoped this paper will contribute to the growing knowledge of social farming as a meaningful therapeutic intervention in mental health occupational therapy practice.

The purpose of this paper is to use theories of institutional logics and institutional entrepreneurship to examine how and why macro-, meso-, and micro-level influences inter-relate in the implementation of integrated transitional care out of hospital in the English National Health Service.

The authors conducted an ethnographic case study of a hospital and surrounding services within a large urban centre in England. Specific methods included qualitative interviews with patients/caregivers, health/social care providers, and organizational leaders; observations of hospital transition planning meetings, community “hub” meetings, and other instances of transition planning; reviews of patient records; and analysis of key policy documents. Analysis was iterative and informed by theory on institutional logics and institutional entrepreneurship.

Organizational leaders at the meso-level of health and social care promoted a partnership logic of integrated care in response to conflicting institutional ideas found within a key macro-level policy enacted in 2003 (The Community Care (Delayed Discharges) Act). Through institutional entrepreneurship at the micro-level, the partnership logic became manifest in the form of relationship work among health and social care providers; they sought to build strong interpersonal relationships to enact more integrated transitional care.

This study has three key implications. First, efforts to promote integrated care should strategically include institutional entrepreneurs at the organizational and clinical levels. Second, integrated care initiatives should emphasize relationship-building among health and social care providers. Finally, theoretical development on institutional logics should further examine the role of interpersonal relationships in facilitating the “spread” of logics between macro-, meso-, and micro-level influences on inter-organizational change.