The shortage of occupational therapists specializing in mental health led to a survey of graduates from nine occupational therapy schools in the New York metropolitan area to determine the factors affecting their specialty choice. The variables examined were derived from a literature review of the specialty choice of psychiatry among medical students. They included personality, academic, clinical, and employment attributes. The results from 411 respondents supported the assumption that fewer occupational therapists were working in mental health than in pediatrics or physical disabilities. The primary factors affecting specialty choice were the fieldwork experience, the feelings of effectiveness in the specialty area, and the perception of employment availability. Recommendations based on a literature review and survey are included.