Mental Health Endorsement FAQs

What is the OTA Mental Endorsement Program?

The Occupational Therapy Australia - Mental Health Endorsement (otaus.com.au) provides recognition of the additional knowledge, skills and experience of occupational therapists focusing their scope of practice on mental health. The endorsement program sets a high standard for our profession and provides an important signal to practitioners, funders, and users of occupational therapy services about what the profession considers the foundation for safe and effective practice.

In addition, the OTA mental health endorsement program provides access to mental health funding through Medicare, Department of Veteran Affairs, WorkSafe Victoria and more. Endorsement is required to practice under the following:

• Medicare Better Access to Mental Health initiative
• Medicare Eating disorder treatment and management plan program
• Department of Veteran’s Affairs (DVA) mental health programs

While OTA mental health endorsement is a prerequisite for those funding programs, and our program is designed to align with their capability requirements, each program has its own guidelines which outline the specific services that can be provided. Individual government funding programs also have their own compliance requirements which practitioners must understand and adhere to. If you intend to provide services through other government funding programs - such as the Medicare Better Access initiative or Department of Veteran’s Affairs (DVA) mental health funding - you should review the requirements for those programs. You can find the link here Allied health professionals - Health and disability - Services Australia

What is the Better Access to Mental Health (BAMH) Initiative?

In 2006, the Government introduced the ‘Better Access to Mental Health Care’ (BAMH) initiative, under which General Practitioners, Paediatricians and Private Psychiatrists could refer to suitably qualified and experienced allied health professionals including occupational therapists for the provision of 10 ‘Focussed Psychological Strategies’ sessions in a calendar year under a Mental Health Care Plan. Medicare Australia has further detail about the Better Access initiative compliance requirements which you can find here - Better Access initiative - supporting mental health care - Services Australia and Note MN.7.1 | Medicare Benefits Schedule (health.gov.au).

Medicare Australia requires specific checks and balances. Consequently, occupational therapy inclusion in this initiative requires occupational therapists to hold Occupational Therapy Australia Mental Health Endorsement, should they wish to be considered by Medicare Australia as ‘suitably qualified and experienced allied health professional.’

How does the Mental Health Endorsement relate to BAMH endorsement?

The BAMH endorsement has been phased out and OTA is no longer accepting BAMH endorsement applications. To apply or re-apply you must go through the new Mental Health Endorsement process.

What are the requirements for eligibility into ‘Better Access to Mental Health’ (BAMH) initiative?

Medicare Australia requires specific checks and balances for a ‘suitably qualified and experienced allied health professional’ to be eligible for the initiative. Occupational therapy inclusion in this initiative requires occupational therapists to hold Occupational Therapy Australia Mental Health Endorsement, should they wish to be considered by Medicare Australia as ‘suitably qualified and experienced allied health professional.’ Occupational Therapy Australia Mental Health Endorsement is a separate process but aligned with government and other funders of health services requirements.

How do I know if I meet Medicare compliance requirements?

While OTA is responsible for endorsing mental health practitioners, setting the eligibility and ongoing requirements for endorsement, it is the responsibility of all occupational therapists providing Medicare services to comply with the requirements associated with each funding program. Meeting OTA requirements does not mean that you are complying with requirements associated with Medicare funding programs. Medicare monitors compliance with program requirements and may audit providers of Medicare funded services to ensure that they are providing services in line with the guidelines of the individual program. For more information about Medicare compliance activities, including education about billing, please refer to the Medicare compliance page Better Access initiative - supporting mental health care - Services Australia and Note MN.7.1 | Medicare Benefits Schedule (health.gov.au).

How do I apply for Occupational Therapy Australia Mental Health Endorsement?

In order to be eligible to provide services under the BAMH Initiative, occupational therapists must hold Occupational Therapy Australia Mental Health Endorsement according to the criteria in force 1 March 2023.

Before applying for Occupational Therapy Mental Health Endorsement note the following:

• Please read the Mental Health Endorsement Application Guide and Mental Health Endorsement Application Form carefully and follow instructions accordingly. 
• Applications will only be assessed using the Mental Health Endorsement Application Form. 
• All applicants must submit a Statutory Declaration for Mental Health Endorsement along with their application. Be mindful that you are applying as an individual. Your application needs to be a true and accurate reflection of your individual skills and experience.
• Applicants must also supply an up-to-date curriculum vitae (CV) along with their application form.

What criteria must I meet to be eligible for Occupational Therapy Australia Mental Health Endorsement?

For a successful application for mental health endorsement applicants must meet the following criteria:

Hold registration to practice as an occupational therapist with the Occupational Therapy Board of Australia.

• Hold current membership with Occupational Therapy Australia.
• Have at least two years of full-time equivalent supervised mental health experience as a qualified occupational therapist. Example: A practitioner working 2.5 days per week exclusively focused on mental health (0.5 FTE) would need to work for four years to gain the necessary mental health experience. Note: your supervisor does not need to be OTA mental health endorsed, however, needs to be experienced in the relevant area of mental health practice.
• Have a minimum of six months of full time equivalent supervised mental health experience in the last five years.
• Have had training and clinical experience in the use of risk assessments (including mental state assessments) and safety planning.
• Ability to demonstrate the mental health capabilities outlined in the Mental Health Endorsement Application Form. We strongly encourage you to read OTA's Mental Health Capability Framework before embarking on the endorsement application process.

 

Why do I need to provide a written application?

A written application to ensure specific checks and balances for a ‘suitably qualified and experienced allied health professional’ is required to be eligible for the initiative. To provide a fair, equitable and transparent process, OTA developed, tested, and refined the endorsement process in collaboration with OTA members. The process enables all parties to demonstrate mental health skills for wider auditing and professional standards with external health organisations. Importantly, while the Occupational Therapy Australia Mental Health Endorsement is a separate process, it is aligned with government and other funders of health services requirements. It is also a transparent process for members to reflect on their practice while holding to internal checks and balances. The written application also forms an important record as part of the application process.

What do the panel members look for in a written application?

In written applications, address the questions clearly by demonstrating your awareness, knowledge base and practical experience in mental health. For instance, in the key capability about mental health legislation, it would be important to highlight specific awareness of relevant mental health legislation for your state, area of practice, and nationally. You may then wish to link this awareness to your experience of this in the workplace, with clear connections to what this means for the clients you see and/or how this might help in your practice. It is important to identify areas of limited skill or experience connecting this to further learning goals.

What do I need to do to maintain endorsement?

Occupational therapists need to:

• Continue to be registered to practice with the Occupational Therapy Board of Australia and meet their registration and competency standards. You can find the link here Occupational Therapy Board of Australia - Registration.
• Focus CPD on Focussed Psychological Strategies/Mental Health (10 hours per year) as part of their broader Occupational Therapy Board of Australia registration requirements.
• Engage in supervision requirements to maintain endorsement.
• Maintain Occupational Therapy Australia general membership. You can find the link here Occupational Therapy Australia - Membership (otaus.com.au).

What does the OTA Audit process involve?

OTA conducts audits to verify ongoing eligibility to be endorsed under its own program and Medicare conducts compliance audits to ensure that practitioners are adhering to funding program guidelines. Importantly, other funders may also conduct audits associated with their own compliance programs.

Our aim is to align the mental health endorsement audit with AHPRA and Medicare guidelines to streamline the process. Consequently, documentation for audit purposes align closely with other compliance programs.

As an endorsed mental health occupational therapist, you are required to undertake activities to develop and maintain your mental health expertise. OTA is required to ensure that all endorsed practitioners adhere to these requirements through regular checks. Endorsed practitioners must undertake 10 hours of mental health specific CPD each year, and, if practicing under Medicare, this must be focused on the therapeutic interventions defined by Medicare as Focused Psychological Strategies (FPS). These CPD activities can contribute to the 20 hours of total CPD each year all occupational therapists are required to complete by the Occupational Therapy Board to maintain registration.

OTA also requires endorsed practitioners to maintain formal supervision arrangements, and to be able to provide details of their supervisor on request. Supervision should generally occur every four to six weeks, though practitioners may benefit from more frequent supervision at early career stages or when developing capability with new client cohorts, mental disorders, or therapeutic interventions. Supervision may include peer supervision.

Practitioners can claim supervision as a component of the 10 hours of FPS CPD, alongside other CPD activities such as formal postgraduate education, workshops, seminars, lectures, journal reading, writing papers, and online training. OTA expects endorsed practitioners to maintain a balance of supervision and formal learning components of their continuing professional development requirements and supervision should not generally comprise more than half of total FPS CPD.

How long should I expect before I hear a reply regarding my endorsement application?

In general, the processing time for applications is approximately 5 to10 weeks, depending on the number being received. Applications are submitted to a panel for assessment and, following this, applicants are then advised of the outcome (successful/not successful), or if further information/clarification may be requested.

What are the benefits of Occupational Therapy Australia Mental Health Endorsement?

There are significant benefits for the occupational therapist and the profession in gaining recognition of our mental health training and skills.

• Endorsement enables occupational therapists to highlight their additional skill set.
• Endorsement enables occupational therapists to demonstrate their commitment to setting a high standard of safe and effective clinical practice in mental health to users of occupational therapy services, other practitioners, and funding bodies.
• Endorsement enables occupational therapists to highlight the occupation lens that we offer within mental health work. This includes our focus on a strengths-based, person-centred, behavioural-oriented, and goal-directed services to improve mental health and wellbeing, and help people access personally relevant and valued roles in life.
• Endorsement enables occupational therapists to demonstrate the capacity to deliver services to people with common to complex conditions across a range of workplace settings.
• Endorsement enables occupational therapist to reflect on their practice, identify potential developmental gaps, and for employers, managers, and business owners to consider whether there may be opportunities to expand their own services in order to represent more wholistic mental health practice.

What happens to my existing BAMH endorsement?

The new OTA Mental Health Endorsement Program recognises mental health occupational therapy expertise and provides access to multiple mental health funding schemes, including Medicare (Focused Psychological Strategies Services by Allied Health Providers / Better Access to Mental Health Program). Those occupational therapists who are currently BAMH endorsed will be transferred to the new Mental Health Endorsement.

What is the intention behind the application process?

While all occupational therapists graduate with foundational skills to practice in mental health, the OTA mental health endorsement acknowledges recognised skill development in mental health to provide therapy for complex mental health needs. The OTA endorsement application process is rigorous with the intention being to protect the occupational therapist, the profession and individuals who may access mental health occupational therapy.

OTA wishes to highlight that having a mental health endorsement involves a level of clinical and professional risk which the occupational therapist must be able to undertake, balance and demonstrate. The emphasis in applications is in demonstrating clinical practice skills, rationale, and processes to show an applicant’s experience in mental health.

What are the obligations of the endorsement panel?

The endorsement panel are responsible for understanding and clarifying the applicant’s capacity to undertake the scope of mental health practice, and management of mental health clinical risks in accordance with governing bodies.

The panel has a responsibility to question an applicant’s adherence to safe, effective, and reflective clinical practice.

The panel can only make judgements based on the information included within the written application.

Can you provide examples of written applications?

The following examples are broad outlines which demonstrate the application of clinical experience to the mental health capabilities. We are grateful for these examples which have been kindly provided by several applicants. As demonstrated, the applicants have focused on providing clinical context and application in the capability questions.

Stimulus Question - Mental health frameworks and system
The occupational therapist understands the local and national mental health system, including relevant mental health, psychosocial disability, and child protection frameworks, and how to support clients to navigate and access appropriate mental health supports.

Example from an OT Application
In my current work funding comes from various state and federal agencies, and the service I work for operates within a [Specific State] Mental Health Service System and incorporates four clinical streams [streams identified, and clinical stream applicant works within described]. The National Practice Standards for the Mental Health Workforce (2013) identify the core knowledge, skills, and attitudes that all mental health clinicians should acquire within two years of commencing in mental health services. The [state] Strategy for Safety and Quality in Public Mental Health Services 2004–2008 provides a framework and plan for developing a safe, high quality, public mental health system. The Industry Occupational Health and Safety Interim Standards for Preventing and Managing Occupational Violence and Aggression in [state] Mental Health Services 2004 provides further guidance in this area. [State] Mental Health and Wellbeing Act 2022 states the laws relating to the treatment of people living with mental illness or experiencing psychological distress.

The service I work in is not a crisis service, however at times young people and families reach out to us who are in crisis. In my role as a clinician, there are times when I need to refer to different organisations within the Mental Health service system as well as to Child Protection Services. I have made referrals to the following tier three services: [services named]. I have made referrals to other tier two organisations including: [services named].

De-identified example provided which included the child/adolescent behaviours of concern, how this presented at home and what was observed in the clinical setting. Details were described about the family make-up, safety and protective concerns, protective factors to help demonstrate the clinical rationale around decision-making. The applicant described the plan undertaken including personal safety planning with the client, the consent and contracting process, and the referral procedure. The applicant described the ongoing clinical intervention provided to the client and how this was balanced with the risk factors.

Stimulus Question - Activity scheduling
The occupational therapist understands how to use activity scheduling as an evidence-based means of supporting recovery and participation in activities of daily living.

Example from an OT Application
For clients at my service, activity scheduling is vital to their recovery and participation in daily activities. I find this is best completed collaboratively, with motivational interviewing incorporated into the planning if there is some resistance. The purpose of activity scheduling is to identify meaningful and purposeful activities and incorporate these into a structured and organised schedule of routines and tasks. [A]ctivity scheduling can be effective in shifting mood states, establishing a sense of predictability and safety, regaining independence and self-agency, improving time management skills, and increasing engagement in activities that are important to the client like employment, studies, and socialising.

Activity scheduling in mental health is often utilised as part of behavioural activation in cognitive therapies and can support a client’s insight and initial understanding of the link between their behaviours, thoughts, and emotions. This is vital in the mental health recovery process.

In my work, I have utilised detailed activity scheduling with a young client with a mood disorder complicated by personality vulnerabilities and a diagnosis of ASD. My client used visual tools such as a calendar, a picture chart, as well as apps on phone for list making, scheduling and reminders. These tools supported my client to establish a regular routine of activities which improved my client’s general hygiene, productivity, occupational engagement, and mood.

Stimulus Question – Paediatric, Child and Adolescent Practice
Knowledge of developmental stages. The occupational therapist understands child and adolescent developmental stages and how these may impact assessment and intervention.

Example from an OT Application
I am confident with integrating my knowledge of social-emotional development in my practice as a mental health OT. I am aware of how diagnoses such as trauma, depression and anxiety may present differently depending on the age of the child. I provide developmental guidance to parents regarding expected behaviours for various stages of development and ways to support the child at each stage. I am aware of how development occurs within in the context of parent -child relationships. When teaching a new skill, my focus is on cultivating an attitude of partnership between the parent and child. My practice is guided by the DIR floortime functional emotional levels. This framework stresses the child’s ability to remain calm and regulated, relate on an emotional level, and read and respond to non-verbal cues, as a foundation for all other development. I am aware of the developmental progression that occurs in order for children to eventually self-regulate their emotions: gradually transitioning from acting out their feelings, to describing what their body is feeling, to describing their feelings in words, to engaging in emotional thinking (making links between ideas and feelings, and actions and their consequences).

The applicant then provided clear practice examples in the application around the integration of paediatric and mental health lens.

You can find information on OTA Mental Health Endorsement here Occupational Therapy Australia - Mental Health Endorsement (otaus.com.au). There is more information on completing the application in the mental health application guide and the Mental Health FAQs. If you are experiencing difficulties in completing a written application, please contact our team here to discuss further.