Real skills for New Zealand’s mental health workforce 2009-95.1

Working as a psychiatric assistant in the late 1980s, Robyn Shearer saw glimpses of the positive impact that mental health workers could make. This despite the fact that she “fell” into psychiatric nursing at a time when the role of Victorian-era mental institutions were declining without any change to their custodial character, with little focus on rehab. Institutions were daunting and sometimes violent places that did little to present psychiatric nurses with a rewarding career. There were critical staff shortages and morale was low. A ministerial inquiry pointed out the immediate problems of a system in need of reform, and in 1998 a Blueprint for Mental Health Services was released. As chief executive of New Zealand’s mental health workforce development and research agency Te Pou, Shearer began driving the development of a radically different workforce, encompassing and at times integrating mental health service consumers, non-governmental organisations and clinicians. The new competency framework is built around seven core “real skills” from which a variety of appropriate services can be developed.

This case can be used to discuss structural reform to an entire system of services, rather than to a particular department or agencies. It could also be used to discuss public health systems more generally, especially relating to mental health.