Physical activities (PAs) play important and effective role in occupational therapy for mental health patients, integrating them in Croatian psychiatric settings presents unique challenges. This study aimed to explore occupational therapists perceptions of PAs, examining their benefits, types, strategies and implementation obstacles. Using a cross-sectional survey with quantitative and qualitative data from 13 Croatian therapists, results highlighted that PAs such as therapeutic walking, progressive muscle relaxation, and medical gymnastics were favored for their adaptability and psychosocial benefits. Therapists reported challenges related to limited resources, logistical constraints, motivational challenges, limited space, and safety concerns. Findings demonstrate that integrating PAs supports occupational balance and community engagement but requires close fitting strategies to address ongoing barriers. This study note the need for adaptable, meaningful occupations in psychiatric care and suggests future directions for enhancing PA feasibility in occupational therapy practices.