Toward an Occupational Justice–Informed Vocational Rehabilitation Framework for Mental Health Service Users in Namibia: A Delphi Study
Munyaradzi Chimara, Hester van Biljon, Fasloen Adams, Lana van NiekerkIntroduction and Rationale
A vocational rehabilitation practice framework is needed to promote shared clinical reasoning among occupational therapists and support consistent, contextually relevant services for mental health service users in Namibia. This study sought expert consensus on foundational components that could guide the future development of such a framework. An occupational justice orientation informed the conceptual framing, viewing vocational rehabilitation as both a therapeutic and advocacy‐based process aimed at promoting equitable access to meaningful work.
Methods
A modified Delphi method was employed to obtain consensus from a panel of 11 experts on 50 statements derived from three datasets. The process included two Delphi survey rounds, conducted using a 3‐point Likert scale via REDCap software. Consensus was defined as 75% or greater agreement on a given item.
Results
Consensus was reached on 38 of the 50 statements (76%). Items endorsed by the panel emphasized foundational strategies, including advancing occupational justice through advocacy for equitable work opportunities, engaging families and employers, applying individualized and client‐centered approaches such as place‐and‐train, and aligning services with national mental health and disability policies. These findings represent areas of shared professional priority rather than a finalized practice framework.
Conclusion
The study demonstrates consensus among experts that vocational rehabilitation practice in Namibia requires attention to both individual work‐readiness support and the broader systemic conditions that shape access to meaningful work for service users. The priorities identified offer a critical evidence base that will inform and shape the final phase of developing the vocational rehabilitation framework.