Entry level education inadequate for practice in pediatrics.

The figures for occupational therapy personnel employed in community mental health centers from 1977 to 1986 quoted in AOTA's Ad Hoc Com· mission's repon Occupational Ther· apy Manpower: A Plan for Progress (AOTA, 1985) and clarified in a Letter to the Editor by Silvergleit (1987) are thought· provoking in relation to our own articles on related topicS (Nee· man & Neeman, 1983, 1987). We learn that, while the total population of OTRs plus COTAs employed in community mental health centers did not change during this decade and stood at around 700, the percentage of OTRs decreased steadily to a low of a mere 16% of total mental health personne1 in 1986 from 4.3% 10 )'ears earlier. In other words, the OTRs in this habitat were an "endangered spe· cies" in 1977, but will be extinct un· less this manpower trend is reversed, and reversed before it is tOO late. ThiS also affects the COTAs in community mental health, because OTRs are needed at least in their role as consul· tants to the COTAs; in the absence of OTRs, COTAs will presumably have to continue working under supervis· ing professionals other than occupa· tional therapists, which is less than ideaL If OTRs in community mental health institutions are to be saved, this manpower demography must be reversed; but that reqUires a knowl· edge of the cause-effect determinants for their endangered status: Is it that the developing occupational therapy manpower shortage drains OTRs from these institutions, and if so, what makes them noncompetitive? Is it a matter of su pply and demand of pro· fessionals, or is it "technological ob· solescence," i.e., displacement of the highly skilled and compassionate therapists, who continue the early tra· dition of "moral treatment" by seek· ing help from the seemingly more cost-effective psychopharmacologist? As a professional in a field related to the latter, [ can see that this norion has inrernal validity, but as a devored OT spouse, I hate to think SOl I am curious about the causes of the OTRs' decelerating trend line in community mental health. Mo Neeman, PhD, FRSC, FRSH WilliamSVille, New York