We heard from mental health and addiction workers who love their jobs and are committed to helping people recover, even to the point of jeopardising their own health and wellbeing. They talked about overwork and burnout and the increasing risk of assaults.
We also heard of the need to attract more people to work in mental health and addiction services – and to retain current staff.
Workers described a lack of career planning, limited training and limited professional development. We heard about a short-term focus on immediate staffing needs, the lack of a clear ‘pipeline’ of new skilled staff and inadequate facilities.
We were told that a markedly different workforce is needed, with more peer-support workers, community-based workers, and Māori and Pacific support services.
Numerous submissions praised services led by people with lived experience of mental distress, psychiatric illness or addiction. We heard that peer-support workers give people a sense of hope that inspires and sustains the healing process and provides a counterbalance to the medical focus of clinical services.
However, peer-support workers described being undervalued, poorly paid and provided with limited training and career options. We heard that, despite some good examples, mainstream services have not fully embraced the concept of incorporating peer-support workers into all aspects of service provision, including design and planning. People wanted peer support to be acknowledged as a basic component of services and to receive better funding.
People were concerned at the lack of cultural competence among workers. They said mainstream health services (especially hospital services) can be alienating and culturally unsafe environments for Māori, Pacific peoples, ethnic minorities, Rainbow communities and the Deaf community. We heard calls for more staff who work entirely within a Kaupapa Māori or Pacific framework.
Having a staff member from one’s own culture was described as crucial to feeling safe and building the trust needed to recover from distress and anxiety. Māori and Pacific staff spoke of regularly working double shifts so Māori and Pacific tāngata whaiora had someone from their culture available to provide help and assurance. The Deaf community submitted strongly about Deaf culture and the need for services to meet their needs.
Some submissions noted that other workers in other sectors need to become competent in recognising and responding to mental distress and addiction in their workplace. Examples cited included teachers, prison staff, police and social workers. We heard that these staff and managers also need practical understanding of issues such as trauma and depression.
Several submitters, including some GPs, said that medical and general practice training in mental health is limited to a theoretical understanding of conventional diagnoses and psychopharmacology. They called for improvements in mainstream primary health care and medical education.