Increasing Opportunities for OT in Mental Health: A Coordinated Approach
By Stephanie Yamkovenko
The American Occupational Therapy Association’s Board of Directors has made increasing opportunities for occupational therapy in mental health practice one of their priorities for fiscal year 2012. The Board specifically aims to have occupational therapy included in a federal definition of behavioral health providers.
Occupational therapy plays a unique role in mental health—one that emphasizes a holistic approach; focuses on function, participation, and partnership; and is based on the evidence and philosophy that people with mental health conditions can and do recover to live meaningful and productive lives.1
Recent advocacy efforts have resulted in positive developments for occupational therapy in mental health. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that establishes conditions of participation for community mental health centers (CMHC). The rule specifies certain criteria the centers would have to meet to be able to receive Medicare reimbursement for the partial hospitalization benefit, including a requirement that the interdisciplinary team working in the centers would have to include a doctor of medicine, osteopathy, or psychiatry; a psychiatric registered nurse; a clinical psychologist; a clinical social worker; an occupational therapist; and other licensed mental health counselors, as necessary. Note that although this proposal is limited to CMHC’s who bill for Medicare partial hospitalization, its impact may be wider.
“The recognition of occupational therapy’s role in mental health is an important step towards increasing opportunities for occupational therapy practitioners in mental health,” says Tim Nanof, MSW, AOTA’s Director of Federal Affairs.
CMS also expressed its intent that all payers would adopt the conditions of participation for community mental health centers, which would greatly expand the scope and reach of the rule. AOTA is preparing and submitting comments to CMS, which are due August 16, in support of the proposed rule. Practitioners interested in submitting their own comments can get more information here.
Meanwhile, AOTA Federal Affairs staff discovered that a list of health care providers defined by federal law as “mental health professionals” exists only in the statute related to the National Health Service Corps (NHSC), which is a scholarship and loan repayment program designed to encourage clinicians to provide health care in areas where access to services is scarce.
Occupational therapy practitioners are not currently on this list of approved mental health professionals for the NHSC, but AOTA is working to introduce a bill to Congress that would add occupational therapy. AOTA believes that the legislation will not result in any increase to the federal budget and will simply create an opportunity for occupational therapy practitioners to apply for the NHSC along with the other approved mental health providers.
For the profession of occupational therapy, however, AOTA’s legislation would have wider reaching effects. AOTA Federal Affairs staff estimate that nearly a third of states in the U.S. used the NHSC’s list to determine which health care providers can be mental health professionals when creating similar lists for state laws. “The states that currently exclude occupational therapy from their list of qualified mental health professionals based on the federal statute would most likely have to modify their state law to include OT if this legislation passes,” says Nanof.
AOTA is working to get bipartisan support for the bill and introduction into both the House of Representatives and the Senate. Once the bill is introduced, AOTA members can write letters to their legislators in support of the bill, check the Legislative Action Center for alerts.
Increasing opportunities for occupational therapy practitioners in mental health settings is not only beneficial to the profession, but also to the clients practitioners serve. Recovery from mental health is possible when the client can define what they want to achieve, and because occupational therapy focuses on the person, environment, and occupation piece practitioners can help clients define their desired outcomes, says AOTA Vice President Virginia Stoffel, PhD, OT, BCMH, FAOTA. “Some clients, although they have the capacity to identify and carry that piece out, haven’t had the opportunity to work with a professional to help them make it explicit. Our unique knowledge really adds to making the difference in helping make recovery possible.”
Stephanie Yamkovenko is AOTA’s staff writer.
1. Champagne, T. & Gray, K. (2011). Occupational therapy’s role in mental health recovery. Retrieved July 26, 2011, from http://www.aota.org/Consumers/Professionals/WhatIsOT/PA/Facts/MH-Recovery.aspx?FT=.pdf