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Hawke’s Bay DHB
district adult
mental health and
addiction services Profile of the 2014 Vote Health
funded workforce
2 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Published in May 2015 by Te Pou o Te Whakaaro Nui
PO Box 108-244, Symonds Street, Auckland, New Zealand.
ISBN 978-0-908322-22-0
Web www.tepou.co.nz
Email [email protected]
Recommended citation:
Te Pou o Te Whakaaro Nui. (2015). Hawke’s Bay DHB district adult mental health and addiction
services: Profile of the 2014 Vote Health funded workforce. Te Pou: Auckland.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
3
Executive summary
In 2014 Te Pou and Matua Raki led an organisation workforce survey of the adult mental health and
addiction services. The survey aimed to describe the size, configuration, roles and ethnicity of the
workforce by DHB area and region. It also aimed to generate greater knowledge about current and
future workforce challenges, knowledge and skill needs, and the strength of cross-sector relationships.
The survey sample included both DHB and NGO organisations receiving Vote Health funding to
deliver adult mental health and addiction services during 2012/13.
The survey results are reported in a number of
companion documents including three national
reports; four regional reports, local DHB reports
and a number of specialist reports on segments of
the workforce. This report summarises the survey
results provided by services in the Hawke’s Bay
DHB district for both mental health and addiction
services. Total FTEs reported in the text and
graphics may differ by up to one FTE due to
rounding.
As at 1 March 2014, the reported Hawke’s Bay
DHB district’s adult mental health and addiction
workforce consisted of 249 FTE positions,
including 25 (10 per cent) vacant FTE positions.
As shown in Figure A, 30 per cent of the Vote
Health funded mental health and addiction
workforce in the Hawke’s Bay DHB district were
located in addiction services and 70 per cent were
located in mental health services.
Overall, for the workforce across mental health and addiction services:
• DHB services reported 62 per cent of the workforce (155 FTE positions)
• NGO services reported 38 per cent of the workforce (94 FTE positions)
• more than half the workforce (51 per cent) were in clinical roles
• non-clinical roles made up 31 per cent of the workforce
• administration and management roles made up 18 per cent of the workforce.
The breakdown was slightly different for addiction services relative to mental health services. A
summary of the breakdown of clinical and non-clinical workforce by provider type (DHB and NGO)
and sector (mental health and addiction) is provided in Figure B.
Figure A. Hawke’s Bay DHB district
workforce by sector
4 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Figure B. Proportion of the workforce in clinical, non-clinical and administration and
management roles by provider type and sector
Support workers made up 30 per cent of the workforce and the majority were reported by NGO
mental health services. Nurses were the next largest occupation group and the majority of these roles
were reported by DHB mental health services. Figure C provides an overview of the primary provider
and sector where key occupational group positions are located.
Figure C. Size of each main occupational group by provider type and sector
Hawke’s Bay DHB district 2014 mental health and addiction workforce
5
When asked to report which knowledge and skills needed some or a large improvement:
• co-existing problems capability received the highest proportion of responses indicating some
or large need for improvement (95 per cent)
• 81 per cent of respondents indicated the need for some or a large improvement in risk
assessment
• 81 per cent of respondents indicated the need for some or a large improvement in physical
health assessment
• 76 per cent of respondents indicated the need for some or a large improvement in using
strengths based approaches to enhance resiliency and recovery with service users.
When asked about knowledge and skills related to cultural competency and working with other
groups, respondents commonly identified that the following needed some or a large improvement:
• 67 to 100 per cent of respondents indicated that their workforce needed some or large
improvement in cultural competence skills for working with Māori, particularly in Māori
health outcome measurement and working in te reo Māori
• 90 to 95 per cent of respondents indicated that their workforce needed some or large
improvement in cultural competence skills for working with Pasifika, particularly in Pasifika
concepts of family values, models of health and languages (67 to 86 per cent indicated large
improvements are needed)
• 86 per cent of respondents reported a need for improvement in skills for working with Asian
ethnic groups.
When asked to rank the top four challenges facing their workforce:
• 67 per cent of respondents ranked managing pressure on staff due to increased complexity in
their top four (12 of 18 responses)
• 67 per cent of respondents ranked managing pressure due to changing service delivery models
in their top four (12 of 18 responses)
• 50 per cent of respondents ranked managing pressure on staff due to increased demand for
service in their top four (9 of 18 responses), and was also ranked as the biggest challenge by 33
per cent of respondents (6 of 18 responses).
When asked to report whether relationships with other sectors or agencies were working adequately,
well or needed improvements:
• mental health services reported their relationships with other addiction services, disability
sector and family violence needed to improve
• some addiction services reported their relationships needed to improve with other mental
health services and other addiction services.
6 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Table of contents
Executive summary ....................................................................................................................................... 2
Glossary .......................................................................................................................................................... 8
1.0 Introduction ........................................................................................................................................... 10
The survey data in context ...................................................................................................................... 11
2.0 Adult mental health services’ workforce .............................................................................................. 13
2.1 Overview ............................................................................................................................................ 13
2.2 Workforce size and service delivered ............................................................................................... 13
2.3 Mental health occupational groups .................................................................................................. 15
2.4 Roles employed and vacant ............................................................................................................... 16
For employed roles .............................................................................................................................. 16
For vacant roles ................................................................................................................................... 18
2.5 Ethnicity of the mental health services’ workforce .......................................................................... 21
3.0 Adult addiction services’ workforce ..................................................................................................... 22
3.1 Overview ............................................................................................................................................ 22
3.2 Addiction workforce size and service delivered .............................................................................. 23
3.3 Addiction occupational groups ........................................................................................................ 24
3.4 Roles employed and vacant ............................................................................................................... 25
For employed roles .............................................................................................................................. 25
For vacant roles ................................................................................................................................... 26
3.5 Ethnicity of the addiction services’ workforce ................................................................................. 28
4.0 Mental health and addiction workforce, service and cross-sector relationship challenges .............. 30
4.1 Knowledge and skill levels ................................................................................................................ 30
General knowledge and skills ............................................................................................................. 30
Cultural competence and working with other groups ...................................................................... 32
4.2 Workforce planning and development challenges .......................................................................... 34
4.3 Cross-sector relationships ................................................................................................................. 35
5.0 Summary of the DHB district mental health and addiction workforce results ................................. 38
6.0 References .............................................................................................................................................. 40
Appendix A: Survey method ....................................................................................................................... 41
Appendix B: Mental health services’ and addiction services’ workforce combined ................................ 42
Hawke’s Bay DHB district 2014 mental health and addiction workforce
7
List of Figures
Figure 1.Hawke’s Bay DHB and NGO services’ adult mental health services’ workforce (n= 176 FTE
positions)...................................................................................................................................................... 13
Figure 2. Proportion of adult mental health services’ workforce located in community,
inpatient/residential and other/unknown locations by NGO and DHBs ................................................ 15
Figure 3. Workforce FTE positions (employed plus vacant) for each main occupational grouping for
DHB and NGO services .............................................................................................................................. 16
Figure 4. Hawke’s Bay DHB and NGO services’ adult addiction workforce (n = 74 FTE positions) ..... 22
Figure 5. Proportion of adult addiction services’ workforce located in community,
inpatient/residential and other/unknown locations by NGO and DHB services. ................................... 24
Figure 6. Addiction services’ workforce (FTE positions employed plus vacant) for each main
occupational grouping by DHB and NGO services................................................................................... 25
Figure 7. Proportion of respondents needing to improve other knowledge and skills (n=21 responses)
...................................................................................................................................................................... 31
Figure 8. Proportion of respondents perceiving a need to improve knowledge and skills for working
with Māori, Pasifika and other groups (n=21 responses) ......................................................................... 33
Figure 9. The biggest workforce challenges for DHB and NGO services (n=18 responses) ................... 35
Figure 10. Strength of DHB and NGO services’ cross-sector relationships (n=21 responses) ............... 37
Figure 11. Mental health services’ and addiction services’ workforce FTE positions (employed plus
vacant) for each main occupational grouping for DHB and NGO services ............................................ 42
List of Tables
Table 1. Population, mental health and addiction consumer and workforce for the Hawke’s Bay DHB
district and Central region as a percentage of regional and national totals ............................................... 11
Table 2. Total Vote Health-funded workforce (FTE positions employed plus vacant) reported in the
survey for the Hawke’s Bay DHB district .................................................................................................... 12
Table 3. DHB and NGO mental health services’ workforce (FTE positions) by service type ..................... 14
Table 4. Adult mental health service workforce FTE positions employed and vacant by roles ................. 18
Table 6. DHB and NGO services’ workforce by service type ....................................................................... 23
Table 6. Adult addiction services’ workforce FTE positions by role............................................................ 26
Table 7. Total number of responses for the Hawke’s Bay DHB district ...................................................... 41
Table 8. Adult mental health services’ and addiction services’ FTE positions employed and vacant by
roles ............................................................................................................................................................... 43
8 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Glossary
Addiction services Alcohol and other drug (AOD) and problem gambling services (PG).
Clinical staff
‘Professionals who are qualified and competent to provide intervention and or
treatment independently, albeit while part of a team’. The above definition was
offered as guidance in Section B of the survey.
Consumers
Within this report the term ‘consumer’ is used to identify people accessing
mental health or addiction services. It is used synonymously with mental health
services’ use of the term ‘service user’.
Community-based
services (home,
community)
Services based within the community that may be delivered in the community
or in hospital outpatient settings.
Dual diagnosis/co-
existing problems
(CEP) services
Services focused on the interaction of substance use and mental health
problems. Also known as dual diagnosis, co-occurring substance use and
mental health disorders, co-existing disorders and comorbidity.
Health funding
Funding associated with Ministry of Health or DHB mental health and
addiction service delivery contracts. This definition of health funding does not
include Ministry of Health whānau ora or primary care funding.
Inpatient services
Services in a medical environment such as a hospital for eligible persons who
are in need of a period of close observation, intensive investigation or
intervention.
Kaupapa Māori
services
Services developed and delivered by providers who identify as Māori. Providers
and teams are expected to use a Māori framework and models of care that
encompass a holistic approach to health, and are cognisant of the health and
wellbeing aspirations of Māori.
Management,
administration and
support services
The management service type provides support and oversight for the
organisation. Some staff employed in management services may do non-
management ‘roles’, eg cultural supervisor, and some management roles may
not be employed within management services.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
9
Pasifika services or
teams
Services or teams that provide a holistic approach that recognises Pasifika
frameworks as necessary to increase the service access rates of Pasifika people
and engage them within a service for the duration of treatment. Services and
teams recognise the significance of the family for wellbeing. Key values for
Pasifika people are acknowledged in the delivery of services: love, respect,
humility, caring, reciprocity, spirit quality, humour, unity and belief in the
importance of family.
Region
The four regions in New Zealand include the following DHB districts of;
Northern region (Northland, Waitematā, Auckland and Counties Manukau
DHBs), Midland region (Waikato, Bay of Plenty, Lakes, Tairāwhiti and
Taranaki DHBs), Central region (Hawke’s Bay, Whanganui, MidCentral, Hutt
Valley, Wairarapa and Capital & Coast DHBs), South Island region (Nelson
Marlborough, West Coast, Canterbury, South Canterbury and Southern DHBs.
Residential services
Accommodation, rehabilitation and support provided in a community
residence to eligible consumers/tangata whaiora with mental health issues eg
supported accommodation, respite.
Respondents
Organisation managers, team leaders and staff working at organisations invited
to complete the survey, who completed and returned valid organisation
workforce survey sections.
Non-health
funding Funding received from sources other than the Ministry of Health or DHBs.
A full list of service and role type definitions are provided in the data dictionary available on the Te
Pou website: http://www.tepou.co.nz/library/tepou/more-than-numbers-organisation-workforce-
survey-data-dictionary
10 Hawke’s Bay DHB district 2014 mental health and addiction workforce
1.0 Introduction
Workforce planning approaches support organisations
and managers to plan for the future service delivery,
anticipate change, manage their workforce, and ensure
that mental health and addiction services provide
consistent, quality services through an appropriately
staffed and skilled workforce (Te Pou o te Whakaaro Nui,
2014b). Profiling the existing workforce, analysing it in
relation to organisational and national strategy, and
identifying gaps between current workforce and future
needs are key components of a workforce planning
approach (Te Pou o te Whakaaro Nui, 2014b, Step 4).
This report profiles the Hawke’s Bay DHB district’s adult mental health and addiction services’
workforce. It presents the 2014 Te Pou and Matua Raki organisation workforce survey results for the
Vote Health funded workforce delivering adult mental health and addiction (alcohol and other drug
and problem gambling) services across the district health board (DHB) provider arm and the non-
government organisation (NGO) sector1. Service respondents were asked to describe their workforce
as at 1 March 2014. The survey aimed to describe the size, configuration, roles and ethnicity of the
workforce by DHB district and New Zealand region. It also aimed to generate greater knowledge
about current and future workforce challenges faced by service providers, their workforce knowledge
and skill needs, and the strength of relationships within and across sectors.
In the Hawke’s Bay DHB district, mental health services provided 13 survey responses identifying a
total of 176 FTE positions (including 20 FTE positions working in combined mental health and
addiction services2). This comprised of five responses from DHB services (104 FTE positions
reported) and 8 responses from NGO services (72 FTE positions reported).
The Hawke’s Bay DHB district also provided 8 responses from addiction services identifying a total of
74 FTE positions. These comprised of four responses from DHB services with a total of 51 FTE
positions reported and four responses from NGO services with a total of 23 FTE positions reported.
Of the four NGO responses, one was received from a problem gambling service with 4 FTE positions.
1 Organisations were excluded from the survey sample if their contracts (identified using the Price Volume Schedule purchase unit codes
and descriptors) were limited to the following: Ministry of Health Te Kete Hauora and Te Ao Auahatanga contracts (whānau ora), mental
health services for older people and aged-care services, primary health services, youth services, disability support services, health promotion
activities, policy and workforce development, telephone helplines, parenting programmes, quality and audit activities. 2 The combined mental health and addiction services FTE have been included in the mental health group
Hawke’s Bay DHB district 2014 mental health and addiction workforce
11
A summary of the survey method is provided in Appendix A of this report. More information about
the survey and its results are reported in six companion reports that describe at national and regional
level the survey method, questions and results, and link the information back to workforce
development and planning principles.3
The survey data in context This section describes the population and service use context for the Hawke’s Bay DHB district in
conjunction with a summary of the Vote Health funded workforce.
• The 2013 NZ population census identified 83,049 adults living in the Hawke’s Bay DHB
district which is 17 per cent of the population in the Central region and 3 per cent of the
national adult population.
• Mental health and addiction services in the Hawke’s Bay DHB district saw 4,278 unique
consumers4, which is 21 per cent5 of the total consumers seen in this region and 4 per cent of
consumers seen nationally.
• Hawke’s Bay DHB district mental health and addiction services surveyed reported their
workforce totalled 249 FTE positions employed plus vacant. This is 16 per cent of the Central
region’s workforce and 29 per cent of the national mental health and addiction workforce
identified by the survey.
Table 1. Population, mental health and addiction consumer and workforce for the Hawke’s Bay DHB
district and Central region as a percentage of regional and national totals
Hawke’s Bay DHB district
Total Proportion of
regional total (%) Proportion of
national total (%)
Population 83,049 17.1 3.4
Unique consumers2 4,278 20.8 4.3
Total workforce reported 249.3 16.1 2.9
Notes:
a The unique consumer numbers are not directly comparable to the workforce numbers because the consumer numbers are based on
consumer’s home location rather than the DHB area where they received services and workforce numbers underestimate the total number of
FTEs due to underreporting in the survey. The percentage of the consumers in the regional and national total will be slightly inflated
because some consumers are included once in the total regional and national figures but are seen by multiple DHBs. See also footnote 4.
3 Survey results in detail with explanation of survey questions, responses received and limitations are explained in the six survey reports
available on Te Pou’s website at: www.tepou.co.nz/more-than-numbers 4 The number of unique consumers is collected from the PRIMHD 2012/2013 dataset of mental health and alcohol and other drug services
and does not include unique problem gambling consumers. 5 This number is inflated, see the note below Table 1.
12 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Table 2. Total Vote Health-funded workforce (FTE positions employed plus vacant) reported in the
survey for the Hawke’s Bay DHB district6
Provider type Mental health
services
Mental health
and addiction#
services
Addiction
services
Total
workforce
DHB 85.9 18.0 51.0 154.9
NGO 69.9 2.0 22.5 94.4
Total 155.8 20.0 73.5 249.3
Notes:
# Combined mental health and addiction FTE have been included in the mental health chapter.
^ Total problem gambling workforce team comprises 4 FTE positions.
Survey respondents identified 5 FTE positions that were funded through sources other than Vote
Health in this DHB district. Of the non-health funded workforce:
• DHB mental health services reported 3 FTE position and NGO mental health services had 1
FTE positions
• NGO AOD and PG services reported a total of 1 FTE positions
• DHB AOD services did not report any non-health funded workforce in their responses.
6 The figures do not include workforce employed in service who report other DHB districts as their main focus but also allocate some time
to this DHB or who work across regions.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
13
2.0 Adult mental health services’ workforce
This section describes the survey results for the Vote Health funded adult mental health services,
including those providing combined mental health and addiction services.7 Information about the
adult addiction services’ workforce including dual diagnosis and co-existing problems services is
provided in Chapter 3 of this report.
2.1 Overview
The majority of the workforce were reported by DHB services (59 per cent) compared to NGO
services (41 per cent). This split is more evenly divided compared to the Central region result and
differs from the national average, where 66 per cent of the national workforce were reported by DHB
services and 34 per cent were reported by NGO services.
Figure 1.Hawke’s Bay DHB and NGO services’ adult mental health services’ workforce (n= 176 FTE
positions)
2.2 Workforce size and service delivered
The adult mental health services’ workforce in both DHB and NGO services who responded to the
survey comprised of 176 FTE positions:
• a total of 154 FTE positions employed (87 per cent)
• a total of 22 FTE positions vacant. Of which:
o DHB services had 20 FTE positions vacant (11 per cent of all positions)
o NGO services had 2 FTE positions vacant (1 per cent of all positions).
7 Tables presenting information about mental health and addiction services’ workforce are provided in Appendix B.
DHB
59%
NGO
41%
14 Hawke’s Bay DHB district 2014 mental health and addiction workforce
For the DHB and NGO mental health services’ workforce:
• 41 per cent of the workforce were reported by inpatient services (73 / 176 FTE positions)
• 32 per cent by community services (56 / 176 FTE positions)
• 17 per cent by residential services (29 / 176 FTE positions)
• 10 per cent by administration and management (18 / 176 FTE positions).
For DHB provider arm mental health services:
• 70 per cent of the workforce were employed in inpatient services (73 / 104 FTE positions)
• 17 per cent by administration and management (18 / 104 FTE positions)
• 13 per cent by community services (13 / 104 FTE positions).
For NGO mental health services:
• 59 per cent of the workforce were reported by community services (43 / 72 FTE positions)
• 41 per cent by residential services (29 / 72 FTE positions).
Table 3 shows Hawke’s Bay district DHB and NGO services’ FTE positions employed, vacant and total
for each main service type. The last column shows the total FTE positions as a proportion of the total
workforce of responding mental health services in this DHB district.
Table 3. DHB and NGO mental health services’ workforce (FTE positions) by service type
Service type
DHB services NGO services
Total workforce
Proportion of total FTE
positions (%)
Employed Vacant Total Employed Vacant Total
Inpatient 65.2 7.5 72.7 - - - 72.7 41.4
Residential - - - 29.3 - 29.3 29.3 16.6
Community 8.7 4.5 13.2 40.6 2.0 42.6 55.9 31.8
Forensic - - - - - - - -
Management 10.0 8.0 18.0 - - - 18.0 10.2
Other - - - - - - - -
Total 83.9 20.0 103.9 69.9 2.0 71.9 175.8 100.0
Note:
The management service type provides support and oversight for the organisation. Some of the staff employed in management services may
do non-management ‘roles’, eg cultural supervisor, and some management roles may not be employed within management services.
Figure 2 summarises the survey responses received from DHB and NGO services in the Hawke’s Bay
DHB district, showing the proportion of FTE positions (employed plus vacant) located in community
settings, inpatient and residential settings and other or unknown locations. The data on location of
services differs from the data about service type because some of the forensic workforce is located in
community settings and some of the forensic workforce is located in inpatient/residential settings.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
15
Figure 2. Proportion of adult mental health services’ workforce located in community,
inpatient/residential and other/unknown locations by NGO and DHBs
2.3 Mental health occupational groups
For mental health services in the Hawke’s Bay DHB district, the largest occupational group was
support workers (38 per cent) followed by nursing (27 per cent). The percentage of the mental health
workforce positions (including vacancies) that were support worker roles is higher than the national
figures (32 per cent) and the Central regional figures (33 per cent).The percentage of the workforce
that were nursing roles is lower than that of the mental health workforce positions for nursing roles
nationally (32 per cent) and in the Central region (33 per cent).
DHB mental health services reported:
• 92 per cent of the medical and other professional support workforce (6 / 7 FTE positions)
• 87 per cent of the nursing workforce (42 / 48 FTE positions)
• 71 per cent of the administration and management workforce (27 / 38 FTE positions).
NGO mental health services reported:
• 70 per cent of support workers (47 / 67 FTE positions)
• 47 per cent of the allied health workforce (7 / 15 FTE positions).
Figure 3 summarises the occupational grouping of the workforce reported by survey respondents by
cultural workers, medical and other professionals, allied health, administration and management,
support workers and nursing.
59
13
41
70 17
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
NGO
DHB
Community Inpatient/residential Other
16 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Figure 3. Workforce FTE positions (employed plus vacant) for each main occupational grouping for
DHB and NGO services
2.4 Roles employed and vacant
This section describes the size of the mental health services’ workforce employed and vacant positions
by workforce roles. Survey respondents were asked to report the role that each person was currently
employed in, rather than their qualification. For example, a registered social worker employed as a
‘family support worker’ would be reported as a ‘family support worker’.
Table 4 shows the FTE positions for each role employed and vacant by DHB and NGO services and
the total workforce (employed plus vacant). A summary of key statistics are reported in the text below.
For employed roles
Clinical roles comprised 38 per cent of the FTE positions employed across the district (58 / 154 FTE
positions). This compares to clinical roles comprising 52 per cent of the total national mental health
FTE positions. Key points in relation to clinical role FTE positions employed are:
• 67 per cent of total clinical roles were nursing (39 / 58 FTE positions)8
• 22 per cent were allied health (13 / 58 FTE positions)
• 11 per cent were medical and other professionals (7 / 58 FTE positions)
8 The nursing occupation group excludes nurse managers
1
6
8
27
42
20
1
1
7
11
6
47
2
7
15
38
48
67
10 20 30 40 50 60 70 80 90 100
Cultural advice and support
Medical and other professionals
Allied health
Administration and management
Nursing
Support workers
DHB NGO Total FTE positions
Hawke’s Bay DHB district 2014 mental health and addiction workforce
17
• DHB services comprised 80 per cent of FTE positions employed for the clinical workforce (46
FTE positions);
o registered nurses comprised 62 per cent of DHB clinical roles(29 / 46 FTE positions)
o nurse practitioner/specialist/educators comprised 11 per cent (5 / 46 FTE positions)
o social workers, 6 per cent (3 / 46 FTE positions)
• NGO services employed 20 per cent of the clinical roles (12 FTE positions);
o registered nurses were the largest clinical role employed by NGO services (5 / 12 FTE
positions)
o clinical psychologists comprised 26 per cent (3 / 12 FTE positions).
Non-clinical roles comprised 42 per cent of the total mental health services’ workforce in the district
(65 FTE positions). Key points in relation to the non-clinical workforce include:
• 97 per cent of the non-clinical workforce were support workers (63 / 65 FTE positions)
• DHB services employed 27 per cent of non-clinical workforce (18 / 65 FTE positions);
o healthcare assistants were 87 per cent of DHB non-clinical roles (15 / 18 FTE
positions)
o the cultural advice and support occupational group comprised 7 per cent (1.3 / 18
FTE positions), in which cultural supervisors had 1 FTE position
o there were no peer support workers (n = 0 / 18)
• NGO services employed 73 per cent of the non-clinical workforce (48 / 65 FTE positions);
o community support workers comprised 40 per cent of NGO services’ non-clinical
workforce (19 / 48 FTE positions)
o residential support workers, 29 per cent (14 / 48 FTE positions)
o peer support workers – consumer/service user, 18 per cent (8 / 48 FTE positions)
o NGO services reported having only 0.6 FTE position in cultural advice compared to
1.3 FTE positions for DHB services. However, as a number of NGO survey
respondents from around the country indicated, these roles were usually unpaid
(volunteers were excluded from the survey) there is likely to be significant
underreporting of this group.
The administration and management occupational group comprised 20 per cent of the mental health
services’ workforce in the district (31 FTE positions). Key points in relation to this workforce include:
• administrators comprised 29 per cent (9 / 31 FTE positions)
• service/team managers, 29 per cent (9 / 31 FTE positions)
• senior managers, 11 per cent (4 / 31 FTE positions).
18 Hawke’s Bay DHB district 2014 mental health and addiction workforce
For vacant roles
There were 22 FTE positions vacant (13 per cent) in this DHB district and the majority of these
vacancies were located in DHB services. As expected, the larger occupational groups had more vacant
FTE positions than the smaller groups:
• For clinical roles, registered nurses had the largest number of vacant FTE positions (8 FTE
positions vacant, 20 per cent).
• For non-clinical roles, the healthcare assistant role had the largest number of vacant FTE
positions (3 FTE positions vacant, 15 per cent).
Family/whānau advisors had a relatively small workforce (6 FTE positions) with a high proportion of
these being vacant (3 FTE position vacant, 50 per cent).
Table 4 shows the FTE positions for each role employed and vacant by DHB and NGO services and
the total workforce (employed plus vacant). The second to last column shows the vacancy rate. The
final column shows the total workforce for each role as a proportion of the total workforce for the
DHB district (FTE positions employed plus vacant).
Table 4. Adult mental health service workforce FTE positions employed and vacant by roles
Roles
DHB services NGO services Total
workforce
(FTE
positions)
Vacancy
rate (%)
Proportion
of total FTE
positions (%)
Employed
Vacant
Employed
Vacant
Clinical roles
Allied health
Addiction practitioner/clinician - - 1.0 - 1.0 - 0.6
Dual diagnosis practitioner/CEP
clinician - - - - - - -
Counsellor - - - - - - -
Educator/trainer 1.0 - 1.0 - 2.0 - 1.1
Occupational therapist 1.0 - - - 1.0 - 0.6
Clinical psychologist 1.0 - 3.0 1.0 5.0 20.0 2.8
Other psychologist 1.0 - - - 1.0 - 0.6
Social worker 2.8 1.0 1.0 - 4.8 20.8 2.7
Other allied health - - - - - - -
Total (allied health) 6.8 1.0 6.0 1.0 14.8 13.5 8.4
Medical and other
professionals
General practitioner - - 0.5 - 0.5 - 0.3
House surgeon 1.0 - - - 1.0 - 0.6
Hawke’s Bay DHB district 2014 mental health and addiction workforce
19
Roles
DHB services NGO services Total
workforce
(FTE
positions)
Vacancy
rate (%)
Proportion
of total FTE
positions (%)
Employed
Vacant
Employed
Vacant
Consultant psychiatrist 2.0 - - - 2.0 - 1.1
Medical officer special scale - - - - - - -
Psychiatric registrar 1.0 - - - 1.0 - 0.6
Liaison/consult liaison 2.0 - - - 2.0 - 1.1
Other medical professionals - - - - - - -
Total (medical and other
professionals) 6.0 - 0.5 - 6.5 - 3.7
Nursing
Registered nurse 28.6 7.4 5.0 1.0 42.0 20.0 23.9
Enrolled nurse - - - - - - -
Nurse practitioner/nurse
specialist/nurse educator 5.0 1.0 - - 6.0 16.7 3.4
Other nursing professional - - - - - - -
Total (nursing) 33.6 8.4 5.0 1.0 48.0 19.6 27.3
Other clinical roles - - - - - - -
Total (clinical roles) 46.4 9.4 11.5 2.0 69.3 16.5 39.4
Non-clinical roles
Support workers
Community development
worker - - - - - - -
Employment worker - - 0.2 - 0.2 - 0.1
Community support worker - - 19.2 - 19.2 - 10.9
Te whānau tautoko /family
support worker - - - - - - -
Healthcare assistant 15.2 2.6 - - 17.8 14.6 10.1
Peer support - consumer and
service user 8.4 - 8.4 - 4.8
Peer support - family and
whānau 1.5 - 1.5 - 0.9
Psychiatric assistant - - - - - - -
Residential support worker - - 14.0 - 14.0 - 8.0
Other support workers 1.0 1.0 3.6 - 5.6 17.9 3.2
Total (support workers) 16.2 3.6 46.9 - 66.7 5.4 37.9
Cultural advice and support
Cultural supervisor 1.0 - 0.4 - 1.4 - 0.8
Poua / kaumātua - - 0.2 - 0.2 - 0.1
Taua / kuia - - - - - - -
20 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Roles
DHB services NGO services Total
workforce
(FTE
positions)
Vacancy
rate (%)
Proportion
of total FTE
positions (%)
Employed
Vacant
Employed
Vacant
Pukenga atawhai / kaiāwhina 0.3 - - - 0.3 - 0.2
Traditional Māori health
practitioner - - - - - - -
Matua - - - - - - -
Pasifika cultural advisor - - - - - - -
Other cultural advisor - - - - - - -
Total (cultural advice and
support) 1.3 - 0.6 - 1.9 - 1.1
Other non-clinical roles - - - - - - -
Total (non-clinical roles) 17.5 3.6 47.5 - 68.6 5.2 39.0
Administration and
management
Administrative and/or technical
support 6.0 1.0 3.0 - 10.0 10.0 5.7
Senior manager 2.0 1.0 1.5 - 4.5 22.2 2.6
Clinical director 2.0 1.0 - - 3.0 33.3 1.7
Professional leader 1.0 - 1.0 - 2.0 - 1.1
Service manager/team leader 5.0 1.0 4.0 - 10.0 10.0 5.7
Consumer advisor/consumer
leader 1.0 - 1.4 - 2.4 - 1.4
Family/whānau advisor 3.0 3.0 - - 6.0 50.0 3.4
Other administration and
management - - - - - - -
Total (administration and
management) 20.0 7.0 10.9 0.0 37.9 18.5 21.6
Total (all roles) 83.9 20.0 69.9 2.0 175.8 12.5 100.0
Note:
Definitions of each role type are provided in the data dictionary available on the Te Pou website:
http://www.tepou.co.nz/library/tepou/more-than-numbers-organisation-workforce-survey-data-dictionary.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
21
2.5 Ethnicity of the mental health services’ workforce
Rising to the Challenge’s (Ministry of Health, 2012) priority actions include improving service
responsiveness to Māori, Pasifika, and Asian and refugee populations. An ethnically diverse workforce
that reflects the population served is one aspect of culturally responsive services.
Of the 13 mental health service respondents, 12 provided information about staff ethnicity:
• DHB services contributed four responses
• NGO services contributed 8 responses
• the total workforce reported for these responses was 144 FTE positions employed.
Of the 12 responses, four respondents reported that they had no staff members in the specified groups.
The following information is an approximate estimation of the ethnic makeup of the workforce based
on the information provided by the person completing the survey in each service.9
There were 56 FTE positions employed in clinical roles for whom staff members’ ethnicity was
reported:
• Māori staff members made up 25 per cent of this workforce (14 / 56 FTE positions)
• Pasifika staff members made up 2 per cent (1 / 56 FTE positions)
• Asian staff members made up 2 per cent (1 / 6 FTE positions).
There were 88 FTE positions employed in non-clinical, administration and management roles for
whom staff ethnicity was reported:
• Māori staff members made up 46 per cent of this workforce (41 / 88 FTE positions)
• Pasifika staff members made up 3 per cent (2 / 88 FTE positions)
• Asian staff members made up 1 per cent (1 / 88 FTE positions).
The ethnic makeup of the workforce is important but is not necessarily a reflection of the cultural
competence of the workforce. These broad ethnic groups are comprised of a number of cultures,
customs and languages and some people may not work from the cultural perspective or work in
contexts that support that perspective. Section 4.1 Knowledge and skill levels indicates there are a
number of cultural competency development needs for the mental health services’ workforce.
9 The survey asked people not to guess people’s ethnicity however we cannot ascertain whether this occurred. Services were asked to leave
this question blank if they could not ascertain information on ethnicity which led to an underreporting of ethnicity information. This means
that the following information is an approximate estimate of the ethnicity of the workforce.
22 Hawke’s Bay DHB district 2014 mental health and addiction workforce
3.0 Adult addiction services’ workforce
This section describes the survey results for the Vote Health funded adult addiction services (ie
alcohol and other drug (AOD) and problem gambling services). The following information does not
include any of the addiction services’ workforce funded through non-health sources or working in
services that receive funding to provide combined mental health and addiction services.10
3.1 Overview
The adult addiction services’ workforce reported by services responding to this survey comprised 74
FTE positions:11
• DHB services had 51 FTE positions employed plus vacant (69 per cent)
• NGO services had 23 FTE positions employed plus vacant (31 per cent).
The proportion of the addiction services’ workforce reported by NGO services in the Hawke’s Bay
DHB district (31 per cent) is smaller than the proportion of the addiction services’ workforce located
in NGOs regionally (44 per cent) and nationally (52 per cent).
Figure 4. Hawke’s Bay DHB and NGO services’ adult addiction workforce (n = 74 FTE positions)
There was one problem gambling service identified by the survey, which had a workforce of 4 FTE
positions. In addition there may be problem gambling staff employed in AOD services that are not
identified here and a number of problem gambling services are not funded by health and thus will not
be included in this summary.
10 The mental health service workforce including combined mental health and addiction service workforce is described in Chapter 2 of this
report. Tables presenting mental health services’ and addiction services’ combined workforce is provided in Appendix B. 11 The remainder of this report describes survey responses relating to these FTE positions.
DHB
69%
NGO
31%
Hawke’s Bay DHB district 2014 mental health and addiction workforce
23
3.2 Addiction workforce size and service delivered
For the DHB and NGO addiction services’ workforce:
• 81 per cent of the addiction workforce was located in community services (59 / 74 FTE
positions)
• 19 per cent was in residential services (14 / 74 FTE positions).
For DHB provider arm services:
• 85 per cent of DHB addiction services’ workforce was located in community services (43 / 51
FTE positions)
• 15 per cent was in residential services (8 / 51 FTE positions).
For NGO services:
• 72 per cent of NGO addiction services’ workforce was located in community services (16 / 23
FTE positions)
• 28 per cent was in residential services (6 / 23 FTE positions).
Of the 23 FTE positions in NGO services, 4 FTE positions (16 per cent) were located in problem
gambling services and the rest were in AOD services.
Table 5 shows the DHB and NGO services’ workforce (FTE positions employed, vacant and in total)
for each main service type. The last column shows the total FTE positions as a proportion of the total
addiction services’ workforce in this DHB district.
Table 5. DHB and NGO services’ workforce by service type
Service type
DHB services NGO services
Total
workforce
Proportion of total
FTE positions
(%)
Employed
Vacant
Total
Employed
Vacant
Total
Inpatient - - - - - - - -
Residential 7.8 - 7.8 6.3 - 6.3 14.1 19.2
Community 41.0 2.2 43.2 15.6 0.6 16.2 59.4 80.8
Forensic - - - - - - - -
Management - - - - - - - -
Other - - - - - - - -
Total 48.8 2.2 51.0 21.9 0.6 22.5 73.5 100.0
Note:
Here ‘management’ relates to services providing management support and does not necessarily correspond with the number of people in
management-specific roles across all organisations.
24 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Figure 5 summarises the survey responses received from DHB and NGO addiction services in the
Hawke’s Bay DHB district, showing the proportion of FTE positions (employed plus vacant) located
in community settings, inpatient and residential settings and other or unknown locations.
Figure 5. Proportion of adult addiction services’ workforce located in community,
inpatient/residential and other/unknown locations by NGO and DHB services.
3.3 Addiction occupational groups
For DHB and NGO addiction services the largest occupational group was allied health12 (48 per cent
of the total addiction services’ workforce) followed by nursing (25 per cent of the total addiction
services’ workforce). This is similar to the Central region (allied health 45 per cent, nursing 17 per
cent) and to the addiction services’ workforce nationally (allied health 46 per cent, nursing 16 per
cent).
DHB AOD services reported:
• 95 per cent of addiction services’ nursing workforce (17 / 18 FTE positions)
• 62 per cent of addiction services’ allied health workforce (22 / 35 FTE positions)
• 95 per cent of all addiction services’ medical and other professional support workforce (3.5 /
3.7 FTE positions).
NGO addiction services reported:
• 54 per cent of addiction services’ administration and management workforce (4 / 7 FTE
positions)
• 42 per cent of addiction services’ support worker workforce (3 / 8 FTE positions).
12 Common roles in the allied health group were addiction practitioner/clinician, counsellor and clinical psychologist.
72
85
28
15
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
NGO
DHB
Community Inpatient/residential Other
Hawke’s Bay DHB district 2014 mental health and addiction workforce
25
Figure 6. Addiction services’ workforce (FTE positions employed plus vacant) for each main
occupational grouping by DHB and NGO services13
3.4 Roles employed and vacant
This section describes the size of the addiction services’ workforce employed and vacant positions by
workforce roles. Survey respondents were asked to report the role that each person was currently
reporting, rather than their qualification. For example, a registered social worker employed as a
‘family support worker’ would be reported as a ‘family support worker’.
For employed roles
Clinical roles comprised 77 per cent of the total addiction services’ workforce across the district (55 /
71 FTE positions). Key points in relation to clinical workforce employed are:
• DHB services employed 74 per cent of clinical roles (41 FTE positions):
o 42 per cent of DHB clinical roles were registered nurses (17 / 41 FTE positions)
o 23 per cent were social workers (9 / 41 FTE positions).
• NGO services employed 26 per cent of clinical roles (14 FTE positions):
o addiction practitioners were the largest clinical role employed by NGO services (10 /
14 FTE positions)
o 18 per cent were social workers (3/ 14 FTE positions)
o registered nurse roles had 1 FTE position in NGOs.
13 There was no workforce in other clinical and other non-clinical roles.
1
4
3
5
17
22
1
4
3
1
14
2
4
7
8
18
35
5 10 15 20 25 30 35 40
Cultural advice and support
Medical and other professionals
Administration and management
Support workers
Nursing
Allied health
DHB NGO Total FTE positions
26 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Non-clinical roles comprised 13 per cent of the total workforce in the district (10 FTE positions). Key
points in relation to the non-clinical workforce include:
• DHB services employed 56 per cent of the non-clinical roles (5 FTE positions):
o 85 per cent were community support workers (4.5 / 5 FTE positions)
o kaiāwhina roles had 1 FTE position in the district.
• NGO services employed 44 per cent of non-clinical roles (4 FTE positions):
o 79 per cent of NGO non-clinical roles were residential support workers (3 / 4 FTE
positions)
o kaumātua roles has 0.2 FTE positions in the district.
The administration and management occupational group comprised 9 per cent of the total addiction
services’ workforce in the district (7 FTE positions). Key points in relation to the administration and
management workforce include:
• administrators comprised 2 of 7 FTE positions
• service/team managers, 5 of 7 FTE positions.
For vacant roles
There were 3 FTE positions (4 per cent) vacant in this DHB district. Clinical psychologists had 2 FTE
positions vacant (30 per cent).
Table 6 shows the FTE positions for each role reported by responding addiction services. The FTE
positions are grouped into employed and vacant by DHB and NGO services. The second to last
column shows the vacancy rate. The final column shows the total workforce for each role as a
proportion of the total workforce for the DHB district (FTE positions employed plus vacant).
Table 6. Adult addiction services’ workforce FTE positions by role
Roles
DHB services NGO services Total
workforce
(FTE
positions)
Vacancy
rate (%)
Proportion
of total FTE
positions (%)
Employed
Vacant
Employed
Vacant
Clinical roles
Addiction practitioner/clinician - - 10.0 - 10.0 - 13.6
Dual diagnosis practitioner/CEP
clinician - - - - - - -
Counsellor 3.8 0.3 - - 4.1 7.3 5.6
Educator/trainer - - - - - - -
Occupational therapist 3.0 0.1 0.5 - 3.6 2.8 4.9
Clinical psychologist 3.8 1.0 - 0.6 5.4 29.6 7.3
Other psychologist - - - - - - -
Social worker 9.4 0.4 2.5 - 12.3 3.3 16.7
Hawke’s Bay DHB district 2014 mental health and addiction workforce
27
Roles
DHB services NGO services Total
workforce
(FTE
positions)
Vacancy
rate (%)
Proportion
of total FTE
positions (%)
Employed
Vacant
Employed
Vacant
Other allied health - - - - - - -
General practitioner - - 0.2 - 0.7 - 1.0
House surgeon - - - - - - -
Consultant psychiatrist 3.0 - - - 3.0 - 4.1
Medical officer special scale - - - - - - -
Psychiatric registrar - - - - - - -
Liaison/consult liaison - - - - - - -
Other medical professionals - - - - - - -
Registered nurse 17.0 0.4 1.0 - 18.4 2.2 25.0
Enrolled nurse - - - - - - -
Nurse practitioner/nurse
specialist/nurse educator - - - - - - -
Other nursing professional - - - - - - -
Other clinical roles - - - - - - -
Total (clinical roles) 40.5 2.2 14.2 0.6 57.5 4.9 78.2
Non-clinical roles
Community development worker - - - - - - -
Employment worker - - - - - - -
Community support worker 4.5 - - - 4.5 - 6.1
Te whānau tautoko /family support
worker - - - - - - -
Healthcare assistant - - - - - - -
Peer support - consumer and
service user - - - - - - -
Peer support - family and whānau - - - - - - -
Psychiatric assistant - - - - - - -
Residential support worker - - 3.3 - 3.3 - 4.5
Other support workers - - - - -
Cultural supervisor - - - - -
Poua / kaumātua - - 0.2 - 0.2 - 0.3
Taua / kuia - - - - - - -
Pukenga atawhai / kaiāwhina 0.8 - - - 0.8 - 1.1
Traditional Māori health
practitioner - - - - - - -
Matua - - - - - - -
Pasifika cultural advisor - - - - - - -
Other cultural advisor - - 0.7 - 0.7 - 1.0
Other non-clinical roles - - - - - - -
Total (non-clinical roles) 5.3 - 4.2 - 9.5 - 12.9
28 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Roles
DHB services NGO services Total
workforce
(FTE
positions)
Vacancy
rate (%)
Proportion
of total FTE
positions (%)
Employed
Vacant
Employed
Vacant
Administration and management
Administrative and/or technical
support - - 2.0 - 2.0 - 2.7
Senior manager - - - - - - -
Clinical director - - - - - - -
Professional leader - - - - - - -
Service manager/team leader 3.0 - 1.5 - 4.5 - 6.1
Consumer advisor/consumer
leader - - - - - - -
Family/whānau advisor - - - - - - -
Other administration and
management - - - - - - -
Total (administration and
management) 3.0 - 3.5 - 6.5 - 8.8
Total (all roles) 48.8 2.2 21.9 0.6 73.5 3.8 100.0
Note.
Definitions of each role type are provided in the data dictionary available on the Te Pou website:
http://www.tepou.co.nz/library/tepou/more-than-numbers-organisation-workforce-survey-data-dictionary
3.5 Ethnicity of the addiction services’ workforce
Of the eight addiction service respondents, seven provided information about staff ethnicity:
• DHB services contributed four responses
• NGO services contributed three responses
• the total workforce reported for these responses was 64 FTE positions employed.
The following information is an approximate estimation of the ethnic makeup of the workforce based
on the information provided by the person completing the survey in each service.14
There were 52 FTE positions employed in clinical roles for which staff members’ ethnicity was
reported:
14 The survey asked people not to guess people’s ethnicity however we cannot ascertain whether this occurred. Services were asked to leave
this question blank if they could not ascertain information on ethnicity which led to an underreporting of ethnicity information. This means
that the following information is an approximate estimate of the ethnicity of the workforce.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
29
• Māori staff members made up 38 per cent of this workforce (20 / 52 FTE positions)
• Pasifika staff members made up 2 per cent (1 / 52 FTE positions)
• there were no FTE positions occupied by Asian staff (0 / 52 FTE positions).
There were 12 FTE positions employed in non-clinical, administration and management roles for
which staff members’ ethnicity was reported:
• Māori staff members made up 86 per cent of this workforce (11 / 12 FTE positions)
• there were no FTE positions occupied by Pasifika staff (0 / 12 FTE positions)
• there were no FTE positions occupied by Asian staff (0 / 12 FTE positions).
The ethnic makeup of the workforce is important but is not necessarily a reflection of the cultural
competence of the workforce. These broad ethnic groups are comprised of a number of cultures,
customs and languages and some people may not work from the cultural perspective or work in
contexts that support that perspective. Section 4.1 Knowledge and skill levels indicates there are a
number of cultural competency development needs for the mental health services’ workforce.
30 Hawke’s Bay DHB district 2014 mental health and addiction workforce
4.0 Mental health and addiction workforce,
service and cross-sector relationship challenges
This section describes responses to survey questions about workforce and service challenges facing
adult mental health and addiction services in the Hawke’s Bay DHB district. The responses reflect the
opinions of respondents, in most cases team leaders and managers, including any input they sought
from others. The main analyses in this chapter combined the responses from mental health and
addiction services. The responses from addiction services are highlighted in the text following the
graphs because they may not be well represented by the combined responses.
4.1 Knowledge and skill levels
All 21 responses received to the survey answered this question (100 per cent of the respondents to this
survey).
• DHB services provided 9 responses, of which four were from mental health services, one was
from a combined mental health and addiction service and four were from addiction services.
• NGO services provided 12 responses, of which 7 were from mental health services, one was
from a combined mental health and addiction service, and four were from addiction services
Respondents were asked to indicate if they thought their staff needed to increase knowledge and skill
levels around key policy and service areas. At least 75 per cent of mental health and addiction service
respondents identified that their workforce needed improvement in 17 out of 31 pre-identified
knowledge and skill areas. Responses indicating low need for improvement cannot be read as an
indication of high levels of workforce competence; such responses may reflect other factors such as a
lack of demand for the particular skill outside specialised services.
Responses to general knowledge and skills are presented first, followed by knowledge and skills related
to cultural competency and working with particular groups. Figure 7 and Figure 8 present combined
responses from DHB and NGO services.
General knowledge and skills
The general knowledge and skill areas most commonly reported as needing some increase or a large
improvement were:
• co-existing problems capability (95 per cent)
• risk assessment (81 per cent)
• physical health assessment (81 per cent)
• using strengths based approaches to enhance resiliency and recovery with service users (76
per cent).
Hawke’s Bay DHB district 2014 mental health and addiction workforce
31
DHB mental health and addiction services reported the need to improve a number of knowledge and
skills. Key needs were in the following areas:
• co-existing problems capability (9 of 9 responses)
• risk assessment (8 of 9 responses)
• physical health assessment (7 of 9 responses).
NGO mental health and addiction services reported the need to improve a number of knowledge and
skills (n= 12 responses). Key needs were in the following areas:
• co-existing problems capability (92 per cent of NGO respondents)
• working with new technologies and IT (83 per cent)
• using strengths based approaches to enhance resiliency and recovery with service users (83
per cent).
Figure 7. Proportion of respondents needing to improve other knowledge and skills (n=21 responses)
29
43
24
48
43
43
48
43
43
48
67
62
57
62
10
5
29
10
19
19
14
24
24
19
10
19
24
33
38%
48%
52%
57%
62%
62%
62%
67%
67%
67%
76%
81%
81%
95%
0 20 40 60 80 100 120
Promotion of restraint and seclusion reduction
initiatives
Knowledge of community resources available in your
area
Screening and brief interventions eg use of AUDIT
tool, sleep hygiene education
Able to respond readily to changes in type of work
Psychological interventions eg cognitive behavioral
therapy, social network, mindfulness
Using outcome measures eg HoNOS, Hua Oranga
Knowledge and use of relevant legislation, regulations,
standards, codes and policies
Working with new technologies and IT
Supporting self-managed care (including on-line
options, 12-step programmes)
Supporting use of peer support
Using strengths-based approaches to enhance
resiliency and recovery with service users
Risk assessment (including suicidality)
Physical health assessment
CEP (co-existing problems) capability
Some increase (%) Large increase (%) Total needing increase
32 Hawke’s Bay DHB district 2014 mental health and addiction workforce
The addiction sector provided 8 of the 21 services that provided information about their knowledge
and skill needs. Outlined below are results specific to the addiction services’ responses.
Most addiction services reported needing to improve workforce knowledge and skills in the following
areas:
• co-existing problems capability (7 of 8 responses)
• supporting use of peer support (7 of 8 responses)
• physical health and risk assessments (7 of 8 responses).
Cultural competence and working with other groups
A number of questions were specifically focused on cultural competency and skills and knowledge
working with other groups.
The cultural competency areas most commonly reported to need some increase or a large increase
were:
• cultural competence for working in te reo Māori me ona tikanga (100 per cent)
• Māori health outcome measurement and assessment e.g. Hua Oranga (100 per cent)
• knowledge of Pasifika cultural models of health (95 per cent)
• confidence in one or more Pasifika languages (95 per cent).
DHB mental health and addiction services reported the need to improve a number of knowledge and
skills. Key needs were in the following areas:
• all knowledge and skill areas for working with Māori (between 7and 9 of 9 responses)
• all knowledge and skill areas for working with Pasifika (9 of 9 responses)
• cultural competence for working with Asian ethnic groups (9 of 9 responses).
NGO mental health and addiction services reported the need to improve a number of knowledge and
skills (n= 12 responses). Key needs were in the following areas:
• Māori health outcome measurement and assessment e.g. Hua Oranga (100 per cent of NGO
respondents)
• cultural competence for working in te reo Māori me ona tikanga (100 per cent)
• knowledge of Pasifika cultural models of health, languages and family values (92 per cent).
Hawke’s Bay DHB district 2014 mental health and addiction workforce
33
Figure 8. Proportion of respondents perceiving a need to improve knowledge and skills for working
with Māori, Pasifika and other groups (n=21 responses)
Most addiction services reported needing to improve workforce knowledge and skills in the following
cultural competency areas:
• Māori health outcome measurement (8 of 8 responses)
• cultural competence for working in te reo Māori me ona tikanga (8 of 8 responses)
• cultural competence for working with Asian ethnic groups (8 of 8 responses).
43
48
57
71
19
24
19
10
29
29
29
48
67
76
81
76
71
5
5
5
5
67
67
71
86
67
67
67
19
14
10
10
24
29
48%
52%
62%
76%
86%
90%
90%
95%
95%
95%
95%
67%
81%
86%
90%
100%
100%
0 20 40 60 80 100 120
Working collaboratively with other services and
agencies
Working with families
Working with children and young persons
Working with older people
Cultural competence for working with Asian ethnic
groups
Knowledge and skills in the engagement process when
working with Pasifika ethnic groups
Knowledge of the basic concepts of tapu across a range
of Pasifika cultures
Confidence in one or more Pasifika languages
Cultural competence for working with Pasifika ethnic
groups
Knowledge of Pasifika cultural models of health
Knowledge of Pasifika family values, structures and
concepts
Knowledge and skills in Māori models of health eg Te
Whare Tapa Whā, Te Pae Mahutonga, Te Wheke
Knowledge and skills in Māori models of engagement
eg pōwhiri process
Cultural competence for working with Māori
Knowledge and skills in whānau-centred practice
(Whānau ora)
Cultural competence for working in te reo Māori me
ona tikanga (language and custom)
Knowledge and skills in Māori health outcome
measurement and assessment eg Hua Oranga
Some increase (%) Large increase (%) Total needing increase
34 Hawke’s Bay DHB district 2014 mental health and addiction workforce
4.2 Workforce planning and development challenges
Respondents were asked to rank from one (highest) to four a list of workforce planning and
development challenges.
Of the 21 responses received to the survey, 18 (86 per cent) answered this question. These included:
• DHB services provided 9 responses, of which four were from mental health services, one was
from a combined mental health and addiction service, and four were from addiction services
• NGO services provided 9 responses, of which six were from mental health services, one was
from a combined mental health and addiction service and two were from addiction only
services.
Figure 9 displays combined responses from DHB and NGO services. When asked to rank the top four
challenges facing the workforce:
• 67 per cent of respondents ranked managing pressure on staff due to increased complexity in
their top four (12 of 18 responses)
• 67 per cent of respondents ranked managing pressure due to changing service delivery models
in their top four (12 of 18 responses)
• 50 per cent of respondents ranked managing pressure on staff due to increased demand for
service in their top four (9 of 18 responses), and was also ranked as the biggest challenge by 33
per cent of respondents (6 of 18 responses).
The challenges most identified by DHB services were:
• managing pressure due to changing service delivery models (89 per cent, 8 of 9 DHB
responses)
• managing pressure on staff due to increased complexity (67 per cent, 6 of 9 DHB responses)
• managing pressure on staff due to increased demand for service (67 per cent, 6 of 9 DHB
responses).
The challenges most identified by NGO services were:
• static or reduced funds (89 per cent, 8 of 9 NGO responses)
• managing pressure on staff due to increased complexity (67 per cent, 6 of 9 NGO responses)
• cost of training and other professional development (56 per cent, 5 of 9 NGO responses).
Figure 9 shows the percentage of respondents giving rankings of one to four for each challenge. The
percentage at the end of the bar represents the proportion of all respondents who included this
challenge in their top four.
Hawke’s Bay DHB district 2014 mental health and addiction workforce
35
Figure 9. The biggest workforce challenges for DHB and NGO services (n=18 responses)
The addiction sector made up six of the 18 responses to this question. This means that the addiction
sector responses are not necessarily well represented when combined with mental health responses.
Outlined below are results specific to addiction responses relating to service and planning challenges.
The challenges most identified by addiction services were:
• recruiting qualified and experienced staff (5 of 6 responses)
• retaining qualified and experienced staff (4 of 6 responses).
4.3 Cross-sector relationships
Respondents were asked to indicate the strength of their relationships with other sectors and agencies.
Overall the responses indicated that more relationships were working adequately or well than needed
improvement.
All of the 21 responses received to the survey answered this question, these included:
• DHB services provided 9 responses, of which four were from mental health only services, one
was from a combined mental health and addiction service and four were from addiction
services
17
6
6
17
33
6
17
11
6
22
6
22
28
6
6
22
11
6
17
17
6
28
17
6
22
6
39%
44%
44%
50%
50%
67%
67%
0 10 20 30 40 50 60 70 80
Retaining qualified and experienced
staff
Cost of training and other professional
development
Recruiting qualified and experienced
staff
Static or reduced funds
Managing pressure on staff due to
increased demand for service
Managing pressure due to changing
service delivery models
Managing pressure on staff due to
increased complexity
Ranked highest (%) Ranked 2nd (%) Ranked 3rd (%) Ranked 4th (%) Total ranked 1-4 (%)
36 Hawke’s Bay DHB district 2014 mental health and addiction workforce
• NGO services provided 12 responses, of which 7 were from mental health only services, one
was from a combined mental health and addiction service and four were from addiction
services
• some of these services did not report the strength of relationships with every sector or agency.
Figure 10 presents combined responses from DHB and NGO services. Relationships working
adequately or well for mental health and addiction DHB and NGO services were with:
• primary health practices (100 per cent of respondents, 20 of 20 responses)
• relationship services (100 per cent of respondents, 12 of 12 responses)
• Work and Income (100 per cent of respondents, 19 of 19 responses).
Relationships needing improvement for mental health and addiction DHB and NGO services were
with:
• other addiction services (48 per cent of respondents, 10 of 21 responses)
• other mental health services (33 per cent of respondents, 7 of 21 responses)
• family violence (33 per cent of respondents, 6 of 18 responses).
Key points for DHB respondents:
• the relationships working adequately or well were with;
o primary health practices (100 per cent of respondents, 9 of 9 DHB responses)
o Work and Income (100 per cent of respondents, 8 of 8 DHB responses)
o Child and adolescent mental health services (100 per cent of respondents, 8 of 8 DHB
responses)
• relationships needing the most improvement were with;
o other addiction services (33 per cent of respondents, 3 of 9 DHB responses)
o other mental health services (33 per cent of respondents, 3 of 9 DHB responses).
Key points for NGO respondents
• the relationships working adequately or well were with;
o primary health practices (100 per cent of respondents, 11 of 11 NGO responses)
o Work and Income (100 per cent of respondents, 11 of 11 NGO responses)
o Police (100 per cent of respondents, 11 of 11 NGO responses)
• relationships needing the most improvement were with;
o other addiction services (58 per cent of respondents, 7 of 12 NGO responses)
o family violence (56 per cent of respondents, 5 of 9 NGO responses).
Figure 10 shows the distribution of responses to this question for each sector. To the left of the zero
axis, the bar shows the proportion of respondents (in percentages) needing to improve relationships
with this sector or organisation. On the right hand side, the first part of the bar shows the proportion
of respondents who thought the relationship was working adequately, and the second part is the
proportion for which relationships were working well. The total responses received for each sector
Hawke’s Bay DHB district 2014 mental health and addiction workforce
37
(excluding those who did not select an option or selected not applicable) is printed on the right side of
the graph.
Figure 10. Strength of DHB and NGO services’ cross-sector relationships (n=21 responses)
The addiction sector made up 8 of the 21 responses to this question. Outlined below are results
specific to the addiction services’ responses relating to cross-sector relationships.
Addiction service respondents reported a number of cross-sector relationships were working
adequately or well, including:
• primary health practices (8 of 8 responses)
• relationship services (8 of 8 responses)
• Police (8 of 8 responses).
Addiction services reported needing improved cross-sector relationships with:
• other addiction services (3 of 8 responses)
• other mental health services (3 of 8 responses).
5
17
21
21
21
21
25
29
29
33
33
48
45
75
53
65
67
42
50
64
64
50
65
53
33
38
33
55
25
47
30
17
37
29
14
14
25
6
18
33
29
19
20
12
19
20
18
19
14
14
14
16
17
17
18
21
21
60 40 20 0 20 40 60 80 100
Primary health practices
Relationship services
Work and Income
Police
Corrections department
General hospitals/emergency departments
Child and adolescent mental health services
Child Youth and Family
Education
Housing New Zealand/accommodation providers
Disability sector
Mental health services for older people
Family violence
Other mental health services
Other addiction services
Needs improvement (%) Working adequately (%) Working well (%) Total responses
38 Hawke’s Bay DHB district 2014 mental health and addiction workforce
5.0 Summary of the DHB district mental
health and addiction workforce results
This report has described the survey results for the adult mental health and addiction services’
workforce in the Hawke’s Bay DHB district. This summary largely duplicates the summary of results
provided in the executive summary but is included again here for completeness.
As at 1 March 2014, the DHB district’s mental health and addiction workforce consisted of 249 FTE
positions, including 25 vacant FTE positions.
Mental health services’ workforce comprised 156 FTE positions (62 per cent of the total workforce
identified). Combined mental health and addiction services workforce comprised 20 FTE positions (8
per cent). The AOD services’ workforce comprised 70 FTE positions (28 per cent) and problem
gambling services’ workforce comprised 4 FTE positions.
DHB services reported 62 per cent of the mental health and addiction workforce in the DHB district
(155 FTE positions) and NGO services reported 38 per cent of the workforce (94 FTE positions). More
than half the workforce (51 per cent) were in clinical roles and 31 per cent were in non-clinical roles.
Administration and management roles made up 18 per cent of the workforce. The breakdown was
slightly different for addiction services relative to mental health services.
For the mental health services’ workforce clinical roles comprised 39 per cent of the FTE positions
(employed plus vacant) and non-clinical roles comprised 39 per cent of the FTE positions (employed
plus vacant). Administration and management roles comprised 22 per cent of the mental health
services’ FTE positions (employed plus vacant). Most of the clinical positions were reported byDHB
services (81 per cent) and most of the non-clinical roles were reported byNGO services (69 per cent).
Support workers and nurses were the two largest occupational groups for mental health services in
this DHB district.
For the addiction services’ workforce clinical roles comprised 78 per cent of the FTE positions
(employed plus vacant) and non-clinical roles comprised 13 per cent of the FTE positions (employed
plus vacant). Administration and management roles comprised 9 per cent of the addiction services’
FTE positions (employed plus vacant). Most of the addiction services’ clinical roles were reported by
DHB services (74 per cent) and most of the non-clinical workforce were in DHB services (56 per
cent). Allied health and nurses were the two largest occupational groups for addiction services in this
DHB district.
Services were asked to report on the degree of improvement they needed in a range of knowledge and
skills. Co-existing problems capability was commonly rated as needing some or a large need for
Hawke’s Bay DHB district 2014 mental health and addiction workforce
39
improvement (95 per cent) as was risk assessment (81 per cent), physical health assessment (81 per
cent) and using strengths based approaches to enhance resiliency and recovery with service users (76
per cent).
Sixty-seven to 100 per cent of respondents indicated that their workforce needed some or large
improvement in cultural competence skills for working with Māori, particularly in Māori health
outcome measurement and working in te reo Māori. Ninety to 95 per cent of respondents indicated
that their workforce needed some or large improvement in cultural competence skills for working
with Pasifika, particularly in Pasifika concepts of family values, models of health and languages.
Cultural competency for working with Asian ethnic groups was also a key need: 86 per cent of
respondents needed improvement in skills for working with Asian ethnic groups.
Managing pressure on staff due to increased complexity (67 per cent of respondents) and managing
pressure due to changing service delivery models (67 per cent of respondents) were commonly rated
as key workforce planning and development challenges. Managing pressure on staff due to increased
demand for service was ranked as the biggest workforce challenge by 33 per cent of respondents.
Both mental health services and addiction services commonly reported that relationships with the
primary health services, relationship services and Work and Income were working adequately or well.
However mental health services reported their relationships with other addiction services, disability
sector and family violence needed to improve. Some addiction services reported their relationships
needed to improve with other mental health services and other addiction services.
40 Hawke’s Bay DHB district 2014 mental health and addiction workforce
6.0 References
Matua Raki. (2011). Addiction services: Workforce and service demand survey 2011 report. Wellington:
Matua Raki.
Ministry of Health. (2012). Rising to the challenge: The mental health and addiction service
development plan 2012-2017. Wellington: Ministry of Health.
Platform Trust. (2007). NgOIT Workforce Survey. Wellington: Platform Trust.
Statistics New Zealand. (2013).New Zealand Census of Population and Dwellings. Wellington:
Statistics New Zealand.
Te Pou o Te Whakaaro Nui. (2014b). The mental health and addiction workforce planning and
forecasting literature review. Retrieved from http://www.tepou.co.nz/library/tepou/mental-
health-and-addiction-workforce-planning-guide
Hawke’s Bay DHB district 2014 mental health and addiction workforce
41
Appendix A: Survey method
Nationally, the organisation workforce survey was sent to the 20 district health boards (DHBs) and
231 non-government organisations (NGOs) that had contracts to provide adult mental health and
addiction services funded by Vote Health in 2012/13.15 Development of the survey questions was
supported by a review of previous workforce surveys and stocktakes including the NgOIT 2007 survey
of the NGO workforce delivering mental health and addiction services (Platform Trust, 2007) and the
2011 Matua Raki survey of addiction services’ workforce and service demand (Matua Raki, 2011).
The survey period ran from 28 March to 15 June 2014. During this time the regional workforce
planning leads, Matua Raki and Te Pou supported survey participants to complete and return their
surveys. Nationally, all 20 DHBs and 169 NGOs completed the survey, giving an overall response rate
of 75 per cent of services. In the Hawke’s Bay DHB district the DHB service and 8 NGOs working in
the district completed the survey.
Table 7. Total number of responses for the Hawke’s Bay DHB district
MH only MH&A Addiction Total
Organisa
tions
Responses
Organisa
tions
Responses
Organisa
tions
Responses
Organisa
tions
Responses
DHB 1 4 1 1 1 4 1 9
NGO 4 7 1 1 4 4 8 12
Total 5 11 2 2 5 8 9 21
The method and limitations of the organisational workforce survey used to generate this data and
detail on population, funding and service access data can be found in the Central regional report
available on the Te Pou website.
15 The survey sample did not include all the organisations working to provide adult mental health and addiction services in New Zealand.
42 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Appendix B: Mental health services’ and
addiction services’ workforce combined
Figure 11 and Table 8 present a summary of the mental health services’ and addiction services’
workforce combined.
Figure 11. Mental health services’ and addiction services’ workforce FTE positions (employed plus
vacant) for each main occupational grouping for DHB and NGO services16
16 Other clinical and other non-clinical FTE are not included in this graph.
2
10
30
30
59
24
2
1
14
21
7
50
4
10
44
50
66
74
0 10 20 30 40 50 60 70 80
Cultural advice and support
Medical
Administration and management
Allied health
Nursing
Support workers
DHB NGO Total FTE positions
Hawke’s Bay DHB district 2014 mental health and addiction workforce
43
Table 8. Adult mental health services’ and addiction services’ FTE positions employed and vacant by
roles
Roles
DHB services NGO services
Total Vacancy rate (%)
Role as % of total FTE
Employed
Vacant
Employed
Vacant
Allied health
Addiction practitioner/clinician - - 11.0 - 11.0 - 4.4
Dual diagnosis practitioner/CEP
clinician - - - - - - -
Counsellor 3.8 0.3 - - 4.1 0.1 1.6
Educator/trainer 1.0 - 1.0 - 2.0 - 0.8
Occupational therapist 4.0 0.1 0.5 - 4.6 - 1.8
Clinical psychologist 4.8 1.0 3.0 1.6 10.4 1.0 4.2
Other psychologist 1.0 - - - 1.0 - 0.4
Social worker 12.2 1.4 3.5 - 17.1 0.6 6.9
Other allied health - - - - - - -
Total (Allied health) 26.8 2.8 19.0 1.6 50.2 1.8 20.1
Medical and other professionals
General practitioner - - 0.7 - 1.2 - 0.5
House surgeon 1.0 - - - 1.0 - 0.4
Consultant psychiatrist 5.0 - - - 5.0 - 2.0
Medical officer special scale - - - - - - -
Psychiatric registrar 1.0 - - - 1.0 - 0.4
Liaison/consult liaison 2.0 - - - 2.0 - 0.8
Other medical professionals - - - - - - -
Total (Medical and other
professionals) 9.5 - 0.7 - 10.2 - 4.1
Nursing
Registered nurse 45.6 7.8 6.0 1.0 60.4 3.5 24.2
Enrolled nurse - - - - - - -
Nurse practitioner/nurse
specialist/nurse educator 5.0 1.0 - - 6.0 0.4 2.4
Other nursing professionals - - - - - - -
Total (Nursing) 50.6 8.8 6.0 1.0 66.4 3.9 26.6
Other clinical roles - - - - - - -
Total (Clinical roles) 86.9 11.6 25.7 2.6 126.8 5.7 50.9
Support workers
Community development worker - - - - - - -
Employment worker - - 0.2 - 0.2 - 0.1
Community support worker 4.5 - 19.2 - 23.7 - 9.5
Te whānau tautoko/family support
worker - - - - - - -
44 Hawke’s Bay DHB district 2014 mental health and addiction workforce
Roles
DHB services NGO services
Total Vacancy rate (%)
Role as % of total FTE
Employed
Vacant
Employed
Vacant
Healthcare assistant 15.2 2.6 - - 17.8 1.0 7.1
Peer support - consumer and service
user - - 8.4 - 8.4 - 3.4
Peer support - family and whānau - - 1.5 - 1.5 - 0.6
Psychiatric assistant - - - - - - -
Residential support worker - - 17.3 - 17.3 - 6.9
Other support workers 1.0 1.0 3.6 - 5.6 0.4 2.2
Total (Support workers) 20.7 3.6 50.2 - 74.5 1.4 29.9
Cultural advice and support
Cultural supervisor 1.0 - 0.4 - 1.4 - 0.6
Kaumātua - - 0.4 - 0.4 - 0.2
Taua/kuia - - - - - - -
Pukenga atawhai/kaiāwhina 1.1 - - - 1.1 - 0.4
Traditional Māori health practitioner - - - - - - -
Matua - - - - - - -
Pasifika cultural advisor - - - - - - -
Other cultural advisor - - 0.7 - 0.7 - 0.3
Total (Cultural advice and support) 2.1 - 1.5 - 3.6 - 1.4
Other non-clinical roles - - - - - - -
Total (Non-clinical roles) 22.8 3.6 51.7 - 78.1 1.4 31.3
Administration and management
Administrative and/or technical
support 6.0 1.0 5.0 - 12.0 0.4 4.8
Senior manager 2.0 1.0 1.5 - 4.5 0.4 1.8
Clinical director 2.0 1.0 - - 3.0 0.4 1.2
Professional leader 1.0 - 1.0 - 2.0 - 0.8
Service manager/team leader 8.0 1.0 5.5 - 14.5 0.4 5.8
Consumer advisor/consumer leader 1.0 - 1.4 - 2.4 - 1.0
Family/whānau advisor 3.0 3.0 - - 6.0 1.2 2.4
Other administration and
management - - - - - - -
Total (Administration and
management) 23.0 7.0 14.4 - 44.4 2.8 17.8
Total (All roles) 132.7 22.2 91.8 2.6 249.3 9.9 100.0
Hawke’s Bay DHB district 2014 mental health and addiction workforce
45
auck l and
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PO Box 108-244, Symonds Street
Auckland 1150, new z eal an d
t +64 (9) 373 2125 f +64 (9) 373 2127
hami l ton
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