Should I stay or should I go? Factors influencing retention of occupational therapists working in mental health services in New Zealand 

Jayne S Webster
17 November 2017

Webster, J. S. (2017). Should I stay or should I go? Factors influencing retention of occupational therapists working in mental health services in New Zealand. (A thesis submitted in partial fulfilment of the Masters of Occupational Therapy at Otago Polytechnic, Dunedin, New Zealand.) [PDF 1.3MB]


Occupational therapists play a central role in working with people with mental health issues through the use of meaningful occupations to enable recovery. In the past three to four decades, there have been numerous discussions, studies and position papers that consider retention and attrition in mental health occupational therapy. 

Retention, turnover, and job satisfaction are multifaceted and involve various personal and professional factors that influence a person's decision to stay, leave, or take future positions within mental health or occupational therapy. Through a review of the literature, it is evident that such factors are not mutually exclusive and are, in fact, interwoven.

The purpose of this study is to identify the factors considered by occupational therapists working in mental health in New Zealand when making their decisions to stay/remain or leave their current, past and future positions and why? An exploratory, quantitative, descriptive, cross sectional survey design was conducted.

Two hundred and thirty-four participants responded to the survey, approximately 68 percent of the mental health occupational therapists holding an Annual Practicing Certificate (APC) with the Occupational Therapy Board of New Zealand. It identified that the factors that have an influence on Aotearoa/ New Zealand mental health occupational therapists’ decisions about leaving, staying or applying for other positions are multifaceted and include both professional
and personal factors.

The survey identified and examined the ‘push, pull, attract’ concepts and factors relevant to OTs working in mental health in Aotearoa / New Zealand. Some of the key findings were that OTs value the direct client contact, opportunities for professional growth and relationships with peers and team, while lack of respect from the team, justifying OT services and role blurring are considerations for leaving positions.

Key issues relate to management factors such as such as recognition and rewards, performance feedback, support from manager, and management style of the team. Stress and burnout for OTs working in mental health is an issue. OTs are wanting autonomy and flexibility with their work with professional development seen as a major benefit. The top attractions for OTs into another position are salary and career promotion.

By developing some retention strategies, particularly at a management level, we can ensure we support OTs to work in mental health throughout their careers. With the current trends showing a rise in demand for mental health services, we can be proactive in ensuring that we maintain, increase and upskill along with promoting OTs working in mental health services in New Zealand to meet the needs of clients by using meaningful occupations to improve health and wellbeing.

Key words: Mental health; Retention; Occupational Therapy; Attrition.


This thesis is available under a Creative Commons Attribution-NonCommercial-NoDerivatives licence CC BY-NC-ND 4.0 International.