State plans more occupational therapy training as field still in limbo
The state plans to expand occupational therapy training, but therapists still lack healthcare worker status in Estonia, limiting access to key digital systems.
Occupational therapy (OT) supports physical and mental health through purposeful activities that help people live independently, from children with developmental delays to patients with a wide range of conditions or recovering from serious trauma.
The Ministry of Social Affairs is planning to expand OT training enrollment from 25 to 40 in 2029–30. Elina Müürsepp, a counselor at the ministry's Department of Health Services, linked the decision to changes in the country's rehabilitation system.
"Team-based work will certainly become more important, and as a result, the role and importance of occupational therapists will grow," Müürsepp said.
The decision marks a reversal from just months ago.
Anne-Mari Viikman, head of the Estonian Association of Occupational Therapists (ETL), recalled alarm last September when a draft consensus agreement proposed removing occupational therapists from the state training order, arguing there was no additional need for them.
According to Viikman, the association's advocacy helped overturn the proposal after officials contacted representatives of the profession before making a final decision.
"We ourselves have repeatedly drawn attention to this," she said. She noted the ETL raised concerns about too limited training enrollment five years ago, and said OSKA labor market studies underestimate demand for occupational therapy.
The need for occupational therapists (OTs), she added, has still never been properly assessed at the national level.
Viikman, who also teaches at Tallinn Health Care College (TTK), said interest in the field remains high and competition for it fierce. Yet even as the state plans to train more of them, occupational therapists remain stuck in legal limbo.
Two years ago, legislative amendments granted speech therapists, physiotherapists (PTs) and clinical psychologists healthcare worker status. OTs, however, were excluded from the change. Müürsepp said the decision was driven by technical and funding issues, not a lack of recognition.
The ministry, she said, supports change. "We consider equating OTs with healthcare workers, as well as granting them access to submit data to the healthcare information system, to be fully justified," the counselor said, adding that discussions over finding a solution are ongoing.
OT missing gap in patient records
The legal gap has real-world consequences. OTs cannot enter data directly into Estonia's national centralized healthcare information system, forcing treatment records to be shared via encrypted email or kept stored within local systems.
That increases doctors' workloads and leaves gaps in patient records, Viikman acknowledged.
"If this data remains in a hospital's local system, other specialists simply won't see what was done in therapy," she explained.
For the profession, the priority is parity with other specialists. Viikman said that includes healthcare worker status and, longer term, a master's degree program in occupational therapy.
The Ministry of Social Affairs said talks on resolving the remaining issues will continue at the start of the new year.
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Editor: Aleksander Krjukov, Aili Vahtla
