Andrea is a 34-year-old female who works from home. Her employer has asked her to travel as part of new duties. Andrea suffers from agoraphobia but wants to be able to meet the job demands. Which mental health service would be the most appropriate for Andrea to overcome her mental health challenges?

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The movement to treat illnesses and manage chronic conditions in the community rather than hospitals and institutions has increased demand for home-based services (Craig, 2012). Home health for people with SMI is primarily covered by Medicare. To receive Medicare-covered services, a person must be "confined" to the home and, typically, not able to leave without the assistance of others or considerable effort (Centers for Medicare and Medicaid Services [CMS], n.d.). Refusing to leave the home due to agoraphobia, paranoia, and/or anxiety and the presence of acute depression, cognitive impairments, positive symptoms, and/or thought disorders that impair judgment and safety meet these criteria (Azok & Tomlinson, 1994; Earle, 1999). Although "'homebound,'" the person can attend adult day care, religious services, medical appointments, and infrequent, short-term, non-medical appointments or events (CMS, n.d.). Persons with physical or medical conditions who have psychiatric symptoms that interfere with occupational performance may also receive mental health occupational therapy (Chapleau & Tessel, 2010). Given the prevalence of occupational performance problems among home health service recipients, practice opportunities are substantial.

Andrea Is a 34-Year-Old Female Who Works from Home