The occupational therapy role in acute psychiatric inpatient units in Australia: A mixed methods study

Occupational therapists are important members of mental health multidisciplinary teams. Despite aligning with mental health reform priorities, including promoting client centredness and participation, the role of occupational therapists in mental health, particularly in acute psychiatric inpatient units, is poorly understood. This study explored the role, function, and scope of practice of occupational therapists in Australian acute psychiatric inpatient units.

This mixed methods, convergent parallel design study combined in-depth interviewing and a cross-sectional survey. Qualitative and quantitative data were analysed using thematic analysis and descriptive statistics, respectively. Both forms of data were analysed separately and then integrated and merged using a contiguous approach. The Occupational Therapy Australia Mental Health Capability Framework guided survey questions and interview guide development. The Model of Human Occupation informed interview guide development, while maintaining an occupational focus across the study.

Consumer involvement was not relevant for this study.

Fifty-nine mental health occupational therapists participated in the study. All completed the survey, and 13 also participated in interviews. Participants were mostly females (83%), aged under 30 (58%), from Victoria (70%), with less than 3 years' experience in acute psychiatric inpatient units (77%). Four themes were identified: (1) a day in the life-same same but different, (2) the underutilised potential of occupational therapy, (3) an evolving practice and increasing demand, and (4) practice shaped by and shaping the environment. Key functions of the role included assessment, completed by survey participants either once a day (37%) or more (16%); individual interventions, completed once a day (48%); group work, completed several times a day (43%); and discharge planning.

Occupational therapists working in Australian acute psychiatric inpatient units share common functions, challenges, and experiences. Limited resources and challenges advocating for their role impact occupational therapists' ability to demonstrate their value within multidisciplinary teams.