Debora A. Davidson, PhD, OTR/L, Clinical Occupational Therapy Editor

Debora A. Davidson, PhD, OTR/L, Clinical Occupational Therapy Editor

Occupational therapists are core team members in a wide array of contexts, including rehabilitation, schools, acute care and long-term care. We provide unique services that complement those of our colleagues, and we are valued for our creativity, practicality and successful results. Our knowledge and skills are considered to be a great fit for clients with physical, developmental and educational needs, but we rarely serve those whose primary concerns involve mental illness. The reasons for this are beyond the scope of this column; I am going to focus on why and how to fix the problem.

According to the National Institute of Mental Health, about 6% of Americans have a serious and persistent mental illness. Services typically consist of medication and crisis management, sometimes with additional counseling or vocational support. ADLs and IADLs may be discussed, but are rarely taught or practiced. Many clients and families express great disappointment with the poor results of this limited treatment.

I have been a “mental health OT” since 1979, and I know we can provide services that will significantly improve these clients’ outcomes. In my work, I regularly get to witness how participation in carefully selected activities produces healing, recovery, joy and life satisfaction for clients with chronic mental health problems. By doing everyday things effectively, my clients show themselves and others that they can be competent, safe and valued members of the larger community. Sometimes the therapy sessions offer the first such experiences in a long time — or ever.

Yes, I am proud to be one of the fewer than 3% of us who identify with mental health practice. I work with my clients through a small private practice, serving people whose families can afford to pay out of pocket. I know that there are many, many potential clients whose needs cannot be met through this model, and I am aware that there are many young OTs who would love to work with this population, if only there were more opportunities. Here is my challenge: Let’s do all that we can to bring occupational therapy into mainstream mental health care. We offer services that provide critical, missing pieces to the current models of service.

Right now, we each have a golden opportunity to vastly increase our presence in mental health, simply by educating federal legislators who will be voting on HR 1037, the Occupational Therapy in Mental Health Act. This law, if passed, promises to add OTs to a small core group of qualified service providers in community mental health facilities. It would create new career opportunities for OTs who want to make a difference in the lives of people with chronic mental illness, and give many people in need access to our services.

Help this effort by going to the American Occupational Therapy Association website’s Legislative Action Center (, where you can easily send an email to your representatives asking them to vote “yes” to HR 1037. Please do this today — time is of the essence!

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