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Occupational Therapists’ Role in Influencing Policies

By Amruta Kalburge

 


We, the people and citizens, live in a world influenced by policies to some degree. In a larger context, a policy is the course of action adopted by the governmental or non-governmental agencies with the main purpose of redistribution of resources, reduction of risks, and protection of rights. As the occupational therapy profession primarily deals with individuals, communities, and populations, the knowledge of policies affecting our daily occupational therapy practice is vital. Additionally, how our profession thrives in the future will depend on favourable policies toward the inclusion of occupational therapy in healthcare provider teams. Therefore, it is imperative that occupational therapists worldwide develop curiosity about the links between policy, occupational therapy practice, and outcomes for our clients.


Examples of policy affecting occupational therapy practice and client outcomes


  1. Cameron & Masterson (1998) described the impact of the National Health Service (NHS) and Community Care Act 1990 on occupational therapy practice in England. Due to the access allowed as a healthcare purchaser and funds allowed to general practitioners (GPs) or medical doctors under this act, GPs started determining which services will be delivered and how services will be delivered. For example, they started limiting access to occupational therapy outpatient services and hiring occupational therapists as direct employers which sustained the influence of the medical model in occupational therapy practice.

  2. Magasi (2012) described the lived experiences of women with disabilities related to the community reintegration process after a nursing home stay in Chicago, USA. These women had physical and mental health impairments along with limited social and economic resources. Policies aimed at reducing expenditure rather than addressing the needs of individuals with disability complicated the community reintegration process for these women.

  3. In Hong Kong, the national occupational rehabilitation policy introduced in 2003 shifted the direction of health care from the provision of services in acute care to long-term rehabilitation and promoted the growth of the occupational therapy profession.

Case Example

Gerald Oler is an occupational therapist working in Botswana. Gerald has developed sustainable community wellness programs in three rural villages and an after-school program for school-aged children to improve their confidence. Gerald believes in grassroots advocacy efforts to achieve policy changes.

Problems/challenges

While working in Botswana, Gerald encountered the following challenges:

  1. The eligibility for disability grants was extended toward people with physical disabilities only.

  2. In some cases, the benefits provided to people with disabilities did not meet their needs. For example, food supplements provided to families with children with disabilities were not adaptable for children with feeding challenges with chewing and swallowing.


Strategies for Policy Change

In order to bring changes to ineffective and incomplete policies mentioned above, Gerald started discussions with people responsible for implementing these policies. Gerald realized that the policy implementors had little knowledge about disabilities and the needs of people with disabilities. He wrote letters to higher offices to educate elected officials about the number of people with disabilities impacted by disabilities in the region, reasons for policies not achieving the desired outcomes, and solutions for inclusive policies. Additionally, he invited elected officials to the disability sensitization gatherings to raise awareness about the challenges of people with disability and formed collaborative relationships in the process. All these efforts resulted in meaningful service provision for people with disabilities in the region.


What can occupational therapists do?

  1. Become a member of the state/ national occupational therapy organizations to stay up to date with policy changes affecting occupational therapy practice and client outcomes.

  2. Network with other occupational therapists who understands the impacts of policies on the occupational therapy profession and clients.

  3. Look up databases to familiarize yourself with local legislators and their agendas.

  4. Analyze client needs critically with a focus on resources available to them, risks for harm, and their occupational rights.

  5. Bring attention to the problem areas of clients or communities in local/state occupational therapy association meetings and explore the role of policy in current conditions.


 

References

Cameron, A., & Masterson, A. (1998). The changing policy context of occupational therapy.

British Journal of Occupational Therapy, 61(12), 556-560

Kwok, H. K. H., Szeto, G. P. Y., Cheng, A. S. K., Siu, H., & Chan, C. C. H. (2011).

Occupational rehabilitation in Hong Kong: Current status and future needs. Journal of Occupational Rehabilitation, 21, S28–S34.

Magasi, S. (2012). Negotiating the social service systems: A vital yet frequently invisible

occupation. OTJR: Occupation, Participation and Health, 32(1), S25-S33.


 

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