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The Role of Occupational Therapists in Mental Health

Author: Carey Hotsky

OT in Mental Health Settings

Occupational Therapists are very versatile practitioners and can work in a variety of settings. One example of a setting in which OTs play a vital role is mental health. Mental health is a core area for occupational therapy practice dating back to the beginning of the profession (OTA, 2019). The roots of the occupational therapy profession are grounded in mental health. The profession evolved from “the moral treatment movement” in the eighteenth century. This movement sought to replace brutality and idleness with kindness and participation in meaningful occupations (Jackman, 2016). Since then, many occupational therapists have strayed away from working in the mental health setting and went into more traditional rehabilitative settings such as acute care, long term care, school systems, and pediatrics. The percentage of occupational therapists in the US who work in a mental health setting is currently around 2.4% (Armstrong, 2020). Some reasons why many OTs don’t pursue careers in mental health settings may include lack of job opportunities, OTs being an underutilized resource, lack of funding and/or resources, and lack of awareness of OTs role in mental health settings (Jackman, 2016). Mental health continues to be an evolving area of practice that needs more occupational therapy practitioners across countless countries. There are also sub settings of mental health in which OTs work in such as inpatient psychiatric settings, outpatient mental health offices, community-based settings such as homeless shelters, and correctional facilities. While the role of OTs in mental health can vary slightly from each setting, the main focus is to enable individuals to engage or re-engage in meaningful occupations by learning the necessary skills (Mitzel, 2017). These therapeutic treatments may be conducted in both individual and group settings.

OTs in Mental Health in Various Countries

The role of occupational therapists practicing in different countries is going to be slightly varied depending on the country and the available resources.

United States:

In the United States, occupational therapists play an important role within mental health settings, however, it is often misunderstood. As mentioned above, occupational therapists work in a variety of sub settings of mental health and their role can vary slightly depending on the setting. Typically, OTs role will include a variety of assessments and both therapeutic group and 1:1 intervention.

Some examples of assessments:

  • ADL assessments

  • Allen Cognitive Level Screen (ACLS)

  • Kohlman Evaluation of Living Skills (KELS)

  • Mini- Mental State Exam (MMSE)

  • Montreal Cognitive Assessment (MOCA)

  • MOHO Screening Tool

  • Occupational Performance History Review

  • Occupational Profile

  • Sensory Processing Measure

  • Sensory Profile

  • Worker Role Interview

Some examples of intervention:

  • Life skills

  • Job readiness

  • Money management

  • Wellness recovery action plans

  • Therapeutic leisure

  • Nutrition

  • Sensory groups

  • Cognitive Behavioral Therapy (CBT)

  • Dialectical Behavioral Therapy (DBT)

  • Advocacy skills

  • Communication skills

  • Routines and habits

(Moving With Hope, 2022).


Ghana is a developing country located in West Africa. In 2013, it was estimated that there were only two occupational therapists working in the country of Ghana. This number has since expanded greatly and occupational therapists play a large role in psychiatric rehabilitation. Occupational therapists work in three main psychiatric hospitals throughout Ghana (Hample & Sundsted, 2015). One of these main hospitals is Accra Psychiatric Hospital which has its own established OT department. The treatments that are provided within this psychiatric hospital in Ghana are similar to the US in terms of providing group and 1:1 based treatments focusing on ADLs, leisure, vocational skills, and community participation. However, they also do provide different treatments such as bead making, dressmaking, and cane weaving (Aph, 2022).


The profession of occupational therapy has been slow to develop throughout China, many individuals living in China do not understand the role of OTs and therefore do not access the offered services (Lavine & Greiner, 2020). Oftentimes in China, disability or illness can be viewed as a punishment for past sins and as a result the individual with the disability or illness must be cared for by family members (Lavine & Greiner, 2020). While the profession of OT is still evolving in China, OTs mainly work in traditional rehabilitation settings such as acute hospitals. OTs do not have a major role in mental health and are rarely seen working in such settings. The mental health system in China is mainly made up of psychiatrists, psychologists, and social workers (Lavine & Greiner, 2020).


Occupational therapy is well established across Australia and have many practitioners working in the field of mental health in both inpatient and outpatient settings. The role of OTs in mental health settings in Australia is similar to the role in the US as they provide both group and individual therapeutic treatments to improve overall health and wellbeing. Some examples of treatments are:

  • Engaging in activities such as vocational or leisure pursuits

  • Developing ways to enhance social participation and community engagement

  • Developing skills such as assertiveness and self-awareness

  • Develop and restore skills through strategies such as goal setting, psychoeducation, experimental learning, adaptive learning strategies, and group and individual work. (OTA, 2019).


Aph. (2022). Accra Psychiatric Hospital - Mental Health Authority. Occupational Therapy Department- Accra Psychiatric Hospital. Retrieved July 19, 2022, from

Hample, Shalyn K. and Sundsted, Maria J., "Occupational Therapy's Role: A Foundational Occupational Therapy Education Resource for Ghana" (2015). Occupational Therapy Capstones. 77.

Jackman, M. (2016, May 17). Occupational therapy in mental health: Understanding the overlap. Psych Central. Retrieved July 22, 2022, from

Lavine, D., & Greiner, B. (2020). Occupational therapy in mainland China: Status, challenges, and Future Directions. Annals of International Occupational Therapy, 3(1), 38–44.

Mitzel, M. (2017, April 3). The role of occupational therapy in mental health settings. PrairieCare. Retrieved July 18, 2022, from

Occupational therapists and mental health interventions. Moving With Hope. (2022, May 10). Retrieved July 18, 2022, from

Response to the Commission’s Issues Paper – The Social and Economic Benefits of Improving Mental Health. (2019). Occupational Therapy Australia. Retrieved July 2022, from



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