Building back better: Imagining an occupational therapy for a post-COVID-19 world.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic, which has disrupted occupations and lives of people around the world, has simultaneously exposed deeply rooted social inequities and structural injustices that have negated the facile claim that "we're all in this together." But the pandemic has also opened up opportunities to imagine other ways of living and doing in the future. This paper imagines some possibilities for shaping occupational therapy's future practices and seeks to illustrate why it is both timely and necessary to re-imagine occupational therapy in 2021. METHODS: Drawing from epidemiological research, the paper explores the inequitable impacts of COVID-19, environmental degradation, and multiple social determinants on people's real opportunities for health, wellbeing, and occupational engagement. FINDINGS: Evidence presented in this paper challenges occupational therapy's individualised approach towards wellbeing and contests the limited parameters of occupations "that matter" that are prioritised and promoted within the profession. In response, the paper seeks to expose the specific, political, economic, and ableist ideology that has effectively shaped the occupational therapy profession's assumptions, models, theories, and the practices these inform. CONCLUSION: Drawing from the "Build back better" approach to post-disaster recovery-with its dual attentions to wellbeing, equity, and inclusivity and to physical, social, cultural, economic, and environmental vulnerabilities-this paper imagines an occupational therapy for a post-COVID-19 world; an occupational therapy that takes seriously the premise that occupations and people are inseparable from their environments; a profession that no longer colludes in individualising problems that are inherently social or in depoliticising the systemic social and economic inequalities that create stress and illness; an occupational therapy that no longer promotes the values of neoliberal ableism; and an occupational therapy dedicated to expanding people's just and equitable opportunities to engage in meaningful occupations that contribute positively to their own wellbeing and the wellbeing of their communities.