Barriers and Facilitators for the Practice of Occupational Therapy in Mental Health: Findings from a Global Practitioner Survey of the World Federation of Occupational Therapists

Background: Occupational therapists are allied health professionals with educational training and capacity to address mental health (MH) needs and reduce MH workforce shortages worldwide. However, occupational therapists working in MH are often underrepresented within the MH and occupational therapy workforce.Aim: Using the perspective of occupational therapists with MH practice, the study aimed to: identify barriers/facilitators for occupational therapy practice in MH, and analyze whether responses vary by respondent- or country-level characteristics.Methods: Secondary ecological analysis of survey responses. The survey was developed and disseminated by the World Federation of Occupational Therapists, through its worldwide network. Ordinal logistic regressions analyzed whether individual- and country-level variables (e.g., demographic, socio-economic factors) affected the response pattern.Results: Survey responses (n= 1102) were obtained from 67 countries or territories. Of the surveyed factors, 66% were rated more often as current barriers for practice, such as: “waiting times”; “services funding”; “intervention costs”; and “therapists availability”. “Screening & referral” and having “training/preparation for MH” were practice facilitators. Response patterns did not substantially vary by respondent or country-related factors. A notable exception was for the Socio-Demographic Index which substantially and significantly affected the response pattern for “safety concerns”: estimate: 11.08; 95% CI:7.09-15.07; p<.0001.Conclusion: This paper reports on a large worldwide survey of occupational therapists on the facilitators/barriers for practice in MH; results can help inform how to strengthen practice in this field. While referral & screening mechanisms should be reinforced to facilitate access to occupational therapy, such actions need to be complemented with adequate service funding, career attractiveness, and therapist availability; otherwise, increased service demands may result in unmet needs and service constraints. Further research is needed to investigate why “safety concerns” was a reported barrier particularly for countries with a lower Socio Demographic Index.