Factors affecting retention of occupational therapists in adult mental health service: A systematic review with narrative synthesis.
Wenting Yan, Sally Ohlsen, Emily Wood
PMID 40336781WHAT IT FOUND
Mental health occupational therapists are more likely to stay when they receive strong team support, supervision, and recognition.
Retention drops when professional identity erodes due to generic roles, high workload, and poor management. Staffing models that dilute OT-specific skills correlate with higher turnover.
Key findings
01Support from colleagues and leaders is the most significant factor for job satisfaction, while difficulties with managers increase intent to leave.
02Professional identity erosion, often caused by generic roles or nursing-focused duties, is linked to burnout and poor retention.
03Chronic understaffing creates a cycle of high workload and unsafe staffing that negatively impacts retention and well-being.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The quality of the included studies was mixed, with several failing to adequately represent the target population or address non-response bias. Nearly half of the included studies were from Australia, which may limit the generalizability of findings to UK or other healthcare systems. Most studies were cross-sectional, meaning they identify associations between factors and retention but cannot prove causation. Grey literature was excluded, which may have omitted relevant local service reports or unpublished data.
Declared interests
The authors declared no potential conflicts of interest. Funding was provided by The Health Foundation (grant number 1275277) for two of the authors.
The easy way to misread this
Do not assume these factors prove causation for retention. The review synthesizes cross-sectional studies that show associations between support, identity, and intent to leave, but it cannot confirm that changing these factors will directly reduce turnover without further prospective evidence.