Providers’ Perspectives Regarding Factors That Influence Access to Occupational Therapy in the Veterans Health Administration Inpatient Psychiatric Setting

Am J Occup Ther. 2026 May 1;80(3):8003185020. doi: 10.5014/ajot.2026.051399.

ABSTRACT

IMPORTANCE: Veterans with occupational performance limitations who are receiving inpatient psychiatric services benefit from occupational therapy. Knowledge of the factors that influence access to occupational therapy services among Veterans receiving inpatient psychiatric care in the Veterans Health Administration (VHA) is limited.

OBJECTIVE: To elicit providers’ perspectives regarding barriers to and facilitators of accessing occupational therapy services in the VHA inpatient psychiatric setting.

DESIGN: Semistructured qualitative interviews were conducted, and themes were identified using a descriptive-and-interpretive approach to analysis.

SETTING: National VHA inpatient psychiatric settings.

PARTICIPANTS: National VHA providers and administrators (N = 16) involved in delivering inpatient psychiatric occupational therapy.

OUTCOMES AND MEASURES: Semistructured qualitative interviews designed to elicit barriers to and facilitators of accessing occupational therapy services in the VHA inpatient psychiatric setting.

RESULTS: Interviews elicited multilevel barriers to accessing inpatient psychiatric occupational therapy, including those at the level of the patient (e.g., Veteran preference), provider (e.g., limited awareness of occupational therapy’s scope of practice), and facility (e.g., occupational therapy staffing issues). Similarly, patient- (e.g., patient education), provider- (e.g., occupational therapy champions), and facility-level factors (e.g., standardized referral process) capable of promoting access to these services were identified.

CONCLUSIONS AND RELEVANCE: This study revealed multilevel determinants of accessing inpatient psychiatric occupational therapy in the VHA. The findings serve as modifiable targets of multifaceted strategies aimed at expanding access to these beneficial services and improving Veteran outcomes. Plain-Language Summary: Although emerging evidence has suggested gaps in access to inpatient psychiatric occupational therapy services in the Veterans Health Administration, knowledge regarding the specific drivers of such gaps has been limited. This study enhances our understanding of factors that shape access to these beneficial services, revealing that factors at the level of the patient (e.g., Veteran preference), provider (e.g., limited awareness of occupational therapy’s scope of practice), and facility (e.g., standardized referral process) influence utilization. These findings lay the foundation for the development of multifaceted strategies that expand access to these beneficial services by enhancing practice and policy.

PMID:41910583 | DOI:10.5014/ajot.2026.051399