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occupational therapy, referral, mental health, policy, therapists, job satisfaction, community resources

agreement among the respondents that a lifelong multidisciplinary treatment is required for the individuals with Parkinson's, and that consideration of psychosocial aspects was as important as the physical aspects. The results of the survey revealed a need for further training in the appropriate occupational therapy intervention for the psychological aspects of treatment.

The current study focused on conducting a cluster analysis on data from 40 community mental health occupational therapists, in order to determine if subgroups of therapists had differing referral prioritization policies. A cluster analysis for a ward was conducted, which demonstrated to have four clusters. The factors that determined the differences in the four subgroups of occupational therapists were : (a) the percentage of role dedicated to specialist occupational therapy or generic work, (b) satisfaction with the balance in these roles, (c) the number of hours worked, and (d) the number of professionally trained team members and the presence of referral prioritization policies. These subgroups were named the aspiring specialists, the satisfied specialists, the satisfied genericists and the chameleons (those not set in applying a consistent or specific policy). On comparison of the subgroups it was found that the policies that led to mainly generic working gave greatest importance to clients who were potentially violent or at risk of suicide. The policies that gave greater importance to occupational therapy role considered referral and the client's diagnosis to be of particular importance. Although the requirement was to focus on specialist occupational therapy interventions, many of the participants did not meet this recommendation. Although some therapists had the skills to provide more specialist services, and showed willingness for the same, they often faced the pressures to work generically. This influenced the referral policies.