Experiences of occupational therapy practitioners from under-represented and diverse backgrounds: A scoping review

Introduction: To improve equity of opportunity, more people from under-represented and diverse populations must enter the occupational therapy profession and require a safe workplace. Therefore, we conducted a scoping review to summarise the experiences of occupational therapists in the workforce from under-represented and diverse backgrounds, identifying barriers, facilitators, and strategies relating to safety, justice, and inclusion. Materials and Methods MEDLINE, PubMed, CINAHL, PsycINFO, AMED, PubMed, and Ovid databases were searched. Articles were screened independently by two reviewers at title and abstract, and full text against inclusion criteria. Descriptive thematic analysis was applied to synthesise qualitative data. Results and Discussion Four overarching themes were identified: othered in practice; selective visibility; harnessing diversity; and belonging within occupational therapy. Othered in practice describes how diverse occupational therapists faced obstacles to belonging, credibility, and receiving recognition. Selective visibility describes how occupational therapists share aspects of their identity, and balance authenticity, with the risk of discrimination. Harnessing diversity describes how diverse occupational therapists saw their identities as strengths, supporting rapport building, challenging injustices, and expanding the profession’s perspectives. Belonging within occupational therapy describes the importance of networks, institutional recognition, and visible role models, and the link between belonging and career progression. Fourteen studies explicitly addressed intersectionality, with race and gender the most common intersections examined. Common barriers were racism and epistemic exclusion. Common facilitators were relationships and mentoring. Conclusion This scoping review mapped the experiences of occupational therapists from under-represented backgrounds, identifying themes of discrimination, microaggressions, disclosure dilemmas, and barriers to belonging. To improve inclusion, we need improved demographic reporting, systems for recruitment equity, and opportunities for mentorship and supports. Future research should be intersectional, exploring multiple under-examined groups, with detailed demographic data reporting. These strategies will support workforce diversity, equity, safety, and ensure a more resilient, inclusive, representative occupational therapy workforce.