The OT Magazine explores the lack of diversity and representation of BAME communities within the occupational therapy profession

Article originally appeared in the Jul/Aug 2020 issue of The OT Magazine.

It feels like currently there are two pandemics going on in the world; COVID-19 and racism. Sadly, COVID-19 will be the easier one to stamp out.

The tragic events of 25 May that saw George Floyd killed by a police officer in Minneapolis, sent waves across the globe. Enraged by another racist murder of a black man by a white police officer, people gathered in solidarity in countries throughout the world to make a stand and demand that action be taken.

The sad reality of these circumstances, is that it has taken a racially motivated murder to be caught on camera, to open people’s eyes to the systemic racism that exists closer to home in their own environments.

The #BlackLivesMatter movement has sparked conversations, actions and it has importantly encouraged people to look at their own workplaces and social environments and raise questions about the diversity, equality and inclusion policies in their own professions.

The occupational therapy profession is no different. The voices of the OT community, practitioners, educators and students, both from BAME communities and not from BAME communities, have spoken up and come together to question the lack of diversity in a profession that champions and thrives on inclusivity. A profession that at its core believes that everyone should be treated equally and that celebrates and integrates itself in the lives of people from all backgrounds, of all ages, of all ethnic diversities and of all abilities.

Why then is the representation of Black, Asian and Minority Ethnic (BAME) groups within the occupational therapy profession so low?

The Royal College of Occupational Therapists (RCOT) announced that BAME representation within the occupational therapy profession was just 8.3%. Acknowledging on Twitter from @theRCOT account:

“BAME representation within the occupational therapy workforce was only 8.3% (NHS Digital 2019 data from Trusts/CCGs in England); this reflects RCOT members’ disclosed ethnicity. Given BAME representation in the UK from census data is 20%, clearly we still have a long way to go.”

On 5 June, RCOT released a diversity statement in response to the events of 25 May, it began with this sentiment:

“RCOT shares the outrage of members, colleagues and friends, and condemns the murder of George Floyd, and continued injustices around the world. We stand in solidarity with our BAME members and colleagues against racism of all kinds.

“To anyone who feels that we’ve been slow in putting out this statement, we hear you. But we wanted to truly reflect on this issue, what it means to us and our members. We’ve done a lot of listening and reflecting on our work so far. To be honest, we’ve also done a bit of soul searching.

“The principles of diversity and equality are core to the practice of occupational therapy and are enshrined within the RCOT Code of Ethics. We believe that all people should be treated with dignity and respect, above all as equal members of society with the same choices, rights and privileges. Discrimination and prejudice have no place in our practice and no place in society.

“As a professional body, we also know that we need a workforce that reflects the population we serve. We recognise that the occupational therapy profession lacks this diversity and we are committed to changing this.”

You can read the full RCOT statement here.

The statement goes on to further acknowledge the lack of diversity in the OT workforce and highlights some ways that they will try to “influence the future makeup of the workforce” and “make our message relevant to BAME communities, through images and storytelling”, before calling on the support of their BAME members to educate them on ways to improve the diversity of the profession.

This statement, while it recognised the lack of diversity in the OT profession and stated a willing commitment to change the landscape of the profession, it simultaneously raised more questions among the BAME OT community than it answered.

Many OTs who read this statement were frustrated and angry with the lack of real action that it outlined. Consequently, through the avenues of social media and virtual networking, a group of OT practitioners, educators and students came together to discuss the profound impact that this statement had on them and the wider OT community. The discussions culminated in an open letter being drawn up by Musharrat Ahmed-Landeryou, Elizabeth Kwarteng, Meroe Dalphinis, organised by Kwaku Agyemang, and supported by a BAMEOT UK network.

The open letter was supported by 48 BAME and non-BAME OTs, students and educators.

The letter states the “hurt and disappointment” that was felt by the BAME OT community due to the timing and content of the statement issued by RCOT. It questions several aspects of the statement, including why RCOT do not have an Equality and Diversity Lead Officer in place. It calls for more transparency regarding the ethnicities of the senior roles at RCOT and for clarification on who will be directly involved in the actions for “refreshing” the RCOT brand to encourage young people of all ethnicities into the profession.

“We came together to write this letter, because of our shared experience of pain, anger and frustration, and to show solidarity with BAME communities who continue to experience structural racism, discrimination, health inequalities, social challenges and injustices. We also know this is not exclusively felt by BAME communities, but we now have allies from all communities, making us stronger together. We stand with JBOT’s (2020) endorsement of WFOT’s (2018) call to action to decolonize the profession and apply “occupational consciousness” as a means to realise this goal. We need authentic, compassionate and determined leaders, developed at all levels of the profession, supported to action their visions to radically transform our organisations, policies, and practices. So that we can thoroughly address structural racism, discrimination, inequity and injustices that exclude individuals and communities.”

RCOT did respond to this open letter on 24 June. However, Elizabeth Kwarteng, one of the authors of the open letter, did comment that it took them several days to respond whilst “it was noted the CEO Julia Scott was liking and replying to tweets. This added to the already very prevalent feeling of being ignored.”

The response to the open letter did once again acknowledge the lack of diversity in the profession and reiterated their commitment to addressing this and to making changes to stamp out racism in the OT profession.

What it didn’t do, was outline a physical action plan for tackling the lack of diversity or actually commit to appointing an equality and diversity officer or any other definitive actions. There is a long way to go to addressing systemic racism and now is not the time for empty words, it is the time for immediate transformative action.

Musharrat J. Ahmed-Landeryou, occupational therapy educator and one of the authors of the open letter shared her thoughts on the response from RCOT:

“Shame on RCOT for their response to the open letter. For not taking the gift of that ‘reaching out arms wide open’ letter, and not showing commitment to change through stating some clear rapidly time-framed transformative actions. I feel broken, I cried in frustration, out of us being ignored again by an institution that has the power to do, but doesn’t. The RCOT response is a moral gesture, to make themselves feel better perhaps, we don’t need this, we need transformative action, that is evidence that RCOT stand for BLACK LIVES MATTER, for BAME LIVES MATTER and are motivated to act. The black lives matter movement is saying, take your oppressive knees off our necks, stand with us and work with us for change, and if you have power it is your responsibility to make visible and sustainable change happen. One action, within RCOT’s gift, is appointing an Equality and Diversity Lead to strategise and influence, and RCOT to genuinely support to embed the role.

“There is a need for introspection from within RCOT, as to why they continue to be complicit in the status quo of structural racism as an organisation, as a staff group and towards their membership. The Big BAME conversation and questions posed don’t really demonstrate this. They have to go to this uncomfortable place; the start of real change is from acknowledging this outright. They can’t continue with the attitude of not seeing, of ignoring, to rationalise that the problem of structural racism doesn’t exist within their organisation, it does. Also, the denial of structural racism by using their catch all phrase “because we are a client-centred profession we are inclusive”. Or tweaking around the edges, because if a system is not working, change by tweaking does not impact change in the system, as it is absorbed by the policies and procedures that enable continuation of the ‘bad’ system. But actions speak louder than words, where are their transformative actions. We need action not talking, not more reviews, because the information RCOT seek has been sitting in pages of commissioned reviews, in black and white, waiting for them to act on it. I am begging the RCOT, please don’t ignore us, be motivated, do something, start somewhere with one authentic action, because when you start, RCOT, you won’t be able to stop.”

You can follow Musharrat J. Ahmed-Landeryou on Twitter @LecturerMish.

The open letter and the RCOT response can be read here.


If you wish to educate yourself further on racism and how to be an effective ally for the Black Lives Matter movement, the first thing you should do is start your own educational journey. Start by recognising your white privilege and do not simply ask members of the BAME community to give up their time to educate you on racism, it is not their job to educate you. There are resources out there in abundance that will help you understand the extent of the racial injustices that occur throughout the world and resources that will help educate you on your own practice as a healthcare professional.

Please find below a list of recommended online resources and books:


Gotta Be OT blog
Black OTs Matter: Changing Your OT Practice to Combat Racism, Address Racial Trauma, and Promote Healing

OT & Chill podcast
L.O.V.E, Let’s talk race

Justice-Based Occupational Therapy (JBOT) newsletter, vol 2, issue 2, June 2020
Response to occupational therapy statements on justice and racism

Ladders 4 Action blog
Guidance for white allies who are trying to help

Resource on Privilege and Intersectionality
Resources to learn and explore the multiple ways that privileges and oppression manifest in our various social, cultural, economic, and bodily identities and situations

Working hard to belong: a qualitative study exploring students from black, Asian and minority ethnic backgrounds experiences of pre-registration physiotherapy education
Hammond, J.A., Williams, A., Walker, S., (2019), BMC Medical Education, 19: 372 DOI

Scorecard Report, Race at work: MacGregor-Smith Review one year on
Department for Business, Energy and Industrial strategy

Recommended reading list contributed by Meroe Dalphinis:

Small Island by Andrea Levy

Windrush Betrayal by Amelia Gentleman

Battle of Brick Lane by AK Azad Konor

On Brick Lane by Rachel Lichtenstein

White Privilege by Kalwant Bhopal

Think like a white man by Nels Abbey

White Fragility by Robin DiAngelo

Why I am no longer speaking to white people about race by Reni Eddo-Lodge


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