Driving is an important occupation, which enables other recovery goals for adult mental health consumers. Multidisciplinary clinicians can support consumers to engage in safe driving practices, which may include referral to a specialist occupational therapy driver assessor. There is presently limited evidence to inform us about the role of occupational therapy driver assessors in mental health and the impact of such services for consumers. Therefore, this study aimed to describe the reasons for referral and the recommendations resulting from driver assessments with adult consumers in a mental health setting and understand the experiences of driver assessors providing these services. A mixed-methods sequential design was employed in this study. Thirty driver assessments (n = 27 consumers) were analysed to identify consumer demographics, assessment recommendations, impact on licence status and rehabilitation outcomes. Focus groups were then conducted with five occupational therapy driver assessors. Quantitative data were analysed descriptively using frequencies and means, while qualitative data were subjected to content analysis. The majority of consumers were diagnosed with psychotic disorders and presented with complex needs. The three primary reasons for referral were (a) cognitive or mental health concerns, (b) consumers directed by licencing authority to undertake driver assessment and (c) consumers wanting to resume driving after not driving for a significant time. Overall, 21 consumers (70%) were recommended to hold a driver licence after completion of an occupational therapy driver assessment. Qualitative themes about the experience of occupational therapy driver assessors included the reality of driver assessments; that outcomes are usually positive, and further support is needed for driver assessments. Driver assessments enable most consumers to return to driving. Occupational therapy driver assessors require greater support to perform this role, including dedicated time and peer support, to facilitate multidisciplinary clinicians and consumers to collaboratively achieve driving outcomes. © 2020 Occupational Therapy Australia.