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Lack of evidence on the effect of interventions is one of the several ongoing challenges facing healthcare services in South Africa. The increasing emphasis on routine outcome measurement has urged occupational therapists to demonstrate the impact of their intervention in mental health. This study aimed to evaluate the change in activity participation of the mental health care users attending an occupational therapy programme METHODS: A one-group pre/post-test design was used. The Activity Participation Outcome Measure (APOM) was administered to measure activity participation of 64 mental health care users. Five measurements were done between admission and follow-up after discharge RESULTS: Majority of the participants were between the ages of 20 - 29 and mainly diagnosed with substance use disorders. The effect sizes, Cohen's d (&gt; 0.80) and Cohen's r (&gt;0.37) demonstrated a significant positive change (p=0.00) across all APOM domains during hospitalisation. An insignificant change (p&gt; 0.05) was noted in the effect sizes during the follow-up stages with a substantial decline in some of the APOM domains indicating that patients were not well-integrated into their communities CONCLUSION: This study revealed the importance of measuring change in participation for shaping clinical practice, to ensure meaningful intervention, and successful integration of MHCUs in their communities  Keywords: routine outcome measurement, activity participation, occupational therapy, mental health, rural context.

Measuring Change in Activity Participation of Mental Health Care Users Attending an Occupational Therapy Programme in Rural South Africa