Occupational therapists (OTs) have long been known for their work in hospitals, communities and social care settings. However, their expertise aligns perfectly with occupational health (OH) and vocational rehabilitation (VR) and there is growing recognition of the significant role OTs can play in promoting workplace health and productivity. As allied health professionals (AHPs), OTs are regulated by the Health and Care Professions Council (HCPC) and follow the Royal College of Occupational Therapists (RCOT) professional standards and code of conduct. With their unique training and holistic approach, OTs are well positioned to contribute within the field of workplace health, but the profession remains underrepresented in that sector.
The Overlap Between Occupational Therapy and Occupational Health (OH)
Across the UK, OH is facing a shortage of skilled professionals, creating an opportunity for OTs to fill an important gap. OTs focus on individuals’ function and meaningful participation in everyday activities – referred to as “occupations” – which contribute to health and well-being. For the majority of adults of working age, this generally includes work. The OT approach is inherently aligned with OH, as they both support individuals to be well in their work.
OTs are trained with a person–environment–occupation approach to intervention, which addresses not only the physical aspects of health but also the psychological, environmental, social and task-specific elements that affect a person’s ability to work. By assessing a person’s functional capabilities and barriers to participation, OTs can play a critical role in ensuring employees remain active, engaged and healthy in the workplace.
The Value of Good Work as a Health Outcome
Good work is not just a means of earning a living; it is a fundamental determinant of health and well-being. Engaging in meaningful employment provides individuals with a sense of purpose, structure and routine, all of which contribute to overall life satisfaction. Research consistently demonstrates that stable employment improves mental health, reduces the risk of physical health problems, and enhances social cohesion. 1,2,3
Supporting individuals with health conditions to remain in work can have far-reaching benefits for society as a whole. Not only does it promote individual well-being but it also reduces the country’s economic burden associated with unemployment, healthcare costs and social welfare.4 When employees feel valued and supported in their roles, they are more likely to contribute positively to their workplaces and communities, which in turn fosters a cycle of health, productivity and engagement.
Why Occupational Therapists (OTs)?
The central focus of OT practice is occupation: engaging in meaningful activities that promote health, well-being and life satisfaction. OTs assess a person’s strengths, capabilities and the challenges they face in their environments, and then the OTs develop tailored interventions to enable individuals to live more-fulfilling lives.
In the context of OH, OTs conduct detailed activity analyses, assess barriers to functional independence, and work to develop, recover or maintain the skills essential for participation in work. This unique perspective enhances traditional OH services, as it allows OTs to recommend adjustments to workplace environments, assist with rehabilitation and help employees manage health conditions in a way that optimises their occupational performance.
The Role of Occupational Therapists (OTs) in Occupational Health (OH): An Evidence-Based Approach
According to the RCOT, there are three levels at which OTs can make a valuable contribution to OH:5
1. Universal level: Work advice for people with health conditions
- Promote early intervention and self-management strategies in the workplace, particularly for employees with physical, psychological, cognitive or sensory impairments.
- Collaborate with GPs and other healthcare providers to offer assessments of individuals’ ability to work through tools such as the AHP’s Health and Work Report, which provides detailed recommendations for workplace accommodations and the completion of the fit note.6
- Encourage employers to value and prioritise their employees’ health and well-being by making OH advice readily accessible.
2. Targeted level: Developing vocational services
- Support individuals with health-related challenges in maintaining or gaining employment, which is achieved by providing tailored vocational interventions.
- Collaborate with employers to develop strategies that address barriers to work, such as health limitations, work roles, environmental factors and job demands.
- Educate employers and employees about managing health conditions that impact work performance, with an emphasis on long-term sustainability for the employee in their role.
3. Specialist level: Vocational rehabilitation (VR) and return-to-work support
- Work closely with OH teams and employers to assess job demands, identify necessary adjustments and create return-to-work plans that facilitate a smooth transition back into the workforce.
- Provide VR, focusing on improving employees’ functional capacity to perform their job roles effectively.
- Engage in multidisciplinary teams to promote holistic care and support, enhancing communication among healthcare professionals, employees and employers.
Extending Occupational Therapy into Occupational Health (OH)
OTs working within OH may find themselves collaborating with OH providers or working directly with human resource (HR) teams. By offering interventions that focus on both physical and mental health, OTs help to build more-inclusive and more-supportive workplaces. They also support employees in managing long-term conditions, preventing workplace injuries and promoting better occupational balance.
A national executive committee, of OTs, has been working with the RCOT to develop a core and extended scope of practice that aligns with OH tasks. The core scope includes the following (as yet unpublished in full; the author was part of this committee):
- Job-demands analysis
- VR
- Assessment of fitness for work
- Risk assessment
- Ergonomic and worksite assessments
- Mental health assessments and workplace adjustments
The extended scope further includes health and well-being promotion, pre-employment screening, and case management of those cases with complex clinical needs – all areas that align closely with OH requirements.
Conclusion: The Future of Occupational Therapists (OTs) in Occupational Health (OH)
Although OTs are still underrepresented in OH services, their holistic, person-centred approach is invaluable for addressing the diverse challenges facing the UK workforce today. As businesses continue to focus on employee well-being and governments recognise the importance of keeping people in work, there is an increasing demand for the unique skills that OTs offer.
With their continued advocacy and awareness-raising efforts, the role of OTs in OH will become increasingly visible, demonstrating their crucial contribution to keeping the workforce healthy, productive and engaged. My mission? Every employee in every workplace should have access to an OT!
References
- Drake, R.E. & Wallach, M.A. (2020). Employment is a critical mental health intervention. Epidemiology and Psychiatric Sciences, 29, pp.e178. DOI: https://doi.org/10.1017/S2045796020000906
- Gedikli, C., Miraglia, M., Connolly, S., Bryan, M., & Watson, D. (2022). The relationship between unemployment and wellbeing: An updated meta-analysis of longitudinal evidence. European Journal of Work and Organizational Psychology, 32(1), pp.128–144. DOI: https://doi.org/10.1080/1359432X.2022.2106855
- Modini, M., Joyce, S., Mykletun, A., Christensen, H., Bryant, R.A., Mitchell, P.B., & Harvey, S.B. (2016). The mental health benefits of employment: Results of a systematic meta-review. Australasian Psychiatry, 24(4), pp.331–336. DOI: 10.1177/1039856215618523
- Dwyer, P., Scullion, L., Jones, K., McNeill, J., & Stewart, A.B.R. (2020). Work, welfare, and wellbeing: The impacts of welfare conditionality on people with mental health impairments in the UK. Social Policy & Administration, 54, pp.311–326. DOI: https://doi.org/10.1111/spol.12560
- Royal College of Occupational Therapists (2019). Good Work for Good Health – The Difference Occupational Therapy Makes. Retrieved from: https://www.rcot.co.uk/sites/default/files/ILSM%20Work%20report%20A4%207pp%20D7.pdf
- Allied Health Professionals Federation (n.d.). Health and Work Report. Retrieved from: https://www.rcot.co.uk/practice-resources/standards-and-ethics/ahp-health-and-work-report
