Supporting People Who Experience Co-Existing Mental Health and Addiction Problems

Meeting the needs of people with co-existing mental health and addiction problems is a challenge faced by many mental health and addiction services and providers. A compounding factor has been the separation of mental health and addiction services which has meant that many people with co-existing mental health and addiction problems have fallen through the cracks between services or had issues not recognized or responded to, leading to poor health outcomes. This chapter describes the approach taken by New Zealand's workforce development centers to support services to improve responsiveness and workforce capability to work with people with co-existing mental health and addiction problems. International research on implementation is briefly summarized before discussion about the impact of the national approach and the barriers to implementation that have emerged. Recommendations for next steps conclude this chapter.

Mental Health Support Workers

This chapter provides the background for policy setting, educational preparation, and emergence of mental health support workers (MHSWs) in New Zealand and examines the work they do in mental health services. New Zealand formally introduced the MHSW role in the early 1990's to provide non-clinical services for mental health consumers or clients through either hospital or community-based services. The work MHSWs undertake and their relationship with other health professionals is discussed. Also discussed, is the relationship that MHSWs have with mental health consumers/clients and the attributes that the MHSW brings to the relationship. Consideration is given to the debate as to whether the role of the MHSW should be regulated, what it means to be considered a health professional, and the possibilities of expanding the scope of practice for MHSWs.

Undergraduate Nursing Curriculum Content Focuses on Emerging Issues that Influence Health

Undergraduate education content could hold the key to nursing workforce development. A professional's attitudes and beliefs are developed during these years, along with the ability to use knowledge and skills to promote mental health and well-being, and work with people experiencing mental health and addiction issues. Historically undergraduate education has targeted the support of illness as opposed to developing and supporting health and well-being. In the past decade research shows there is a close relationship between mental illness and addiction with physical health and early brain development. This chapter explores how the Modern Apprenticeship nursing curriculum prepares undergraduate nurses to critically think about a person or family's health at every encounter using a biopsychosocial framework by understanding that all of health is connected and the development of the brain in the early years is key to health and well-being.

Rural Mental Health Workforce Development in Hawai'i and the US-Affiliated Pacific Islands

Working in Hawai'i and the U.S.-Affiliated Pacific Islands presents unique challenges and opportunities for mental health workforce development. This chapter presents previous, current, and future efforts aimed at not only increasing the size of the workforce but also developing a better trained workforce for existing professionals. The authors draw from their experiences at the Hawaii/Pacific Basin Area Health Education Centers (AHEC), one of the only organizations performing medical, public health, and mental health workforce development across the Pacific Region, to explore culturally appropriate initiatives and interventions. Programs targeting a range of audiences from youth to adults, students to professionals, and patients/clients to caregivers are discussed. The chapter emphasizes health career pathway programs for youth and young adults wishing to enter the health workforce and a variety of educational development and continuing education opportunities for professionals. Specific mental health workforce initiatives are described.

Behavioral Health Workforce Development in the United States

Mental health and substance use conditions are among the most prominent causes of illness and disability in the U.S. Yet less than half of the individuals with these conditions receive treatment (Substance Abuse and Mental Health Services Administration [SAMHSA], 2011; Office of National Drug Control Policy [ONDCP], 2013). While there are many impediments to accessing care, the absence of a workforce that is of sufficient size and adequately trained is a significant factor (Olfson, 2016). This chapter provides an overview of the U.S. behavioral health workforce and describes seven strategic areas in which activity has been undertaken to strengthen it. The initiatives of the Annapolis Coalition on the Behavioral Health Workforce are presented to highlight these strategic areas, which include assessment and planning; competency identification and development; roles for persons in recovery and family members; integrated care and interprofessional collaboration; workforce development in substance use; diversity and cultural competency; and knowledge dissemination and adoption of best practices.

Workforce Development and E-Competency in Mental Health Services

Online chat and email are two of the most popular ways of providing e-mental health. Online chat is synchronous communication in a virtual chat room where client and counselor meet at the same time. In contrast, email is referred to as asynchronous because it can be accessed without the synchronous presence of client and counselor. There has been a rapid increase in the demand for chat and email over recent years and much of the demand has been met by services that have traditionally provided helplines or crisis support. This chapter provides an overview of the key issues associated with the delivery of e-mental health services and workforce development. This includes an examination of the range of options for providing e-mental health and key issues to consider when working online. The chapter concludes with a brief exploration of issues associated with client suitability for e-mental health via chat and email.

Developing a Culturally Competent Workforce that Meets the Needs of Pacific People Living in New Zealand

This chapter provides an overview of innovative Pacific workforce development initiatives. Pacific people have higher rates of mental illness, substance abuse, and suicide attempts, as well as lower rates of service access compared to New Zealand's general population. Pacific families also tend to have high and complex mental health needs, traditional cultural worldviews that are different from the dominant western mental health paradigms, and a workforce with severe under-representation of Pacific people. National non-government organization (NGO) Le Va, was established to reduce ethnic disparities in the access to, and quality of mental health and addictions services, through a targeted workforce development strategy to achieve better outcomes for Pacific people. This chapter specifically describes three of Le Va's programmes designed to increase Pacific workforce capacity and capability, and cultural competency of the “mainstream” workforce. These include cultural competency training, effective upskilling and growth through scholarships and support, and leadership development.

A Critique on the Factors that Influence Mental Health Workforce Training in Developing Countries

This chapter will discuss the training of the mental health workforce in developing countries and make comparison with the developed world from where many of the systems and practices originate. All countries are different in the various factors that affect mental health care, mental health promotion, and mental health personnel training. But there are common themes. The relevancy of mental health workforce training is affected by treatment theory, the prevalence and burden of disorders in the country, the types of personnel available and involved in caring for the disabled, and the environments and resources available at country level. The realities and limitations of each country influences the types of people available for workforce training, the training approaches that are practical and can be sustained, the type of educational technologies available, and the retention of personnel once trained. These are the major themes addressed in this chapter with particular reference to the least developed countries.

Key Initiatives in New Zealand's Adult Mental Health Workforce Development

This chapter describes a nationally led approach to workforce development by analyzing three workforce development initiatives within the adult mental health and addiction sector in New Zealand. New Zealand has been on an important and critical journey with regards workforce development over the past 15 years, one which has significantly altered the way services are delivered. In order to understand this journey, some background information relevant to New Zealand will be provided covering the context of mental health, epidemiology of mental health illness, service delivery, use of evidence based treatments, as well as funding and investment in workforce development. The three workforce development initiatives are then described: 1) key knowledge, skills, values and attitudes for all people working in mental health and addiction services, 2) development of an outcomes culture, and 3) post graduate clinical training for nurses and allied health professionals.

Mental Health and Addictions Workforce Development

This chapter addresses changes in the conceptualization of workforce development and its implications for mental health and addiction1 workers, services, and sectors. First we provide an overview of the background, historical and contextual factors impacting current approaches to workforce development. Next, an examination of systems thinking, service delivery models and goals, workforce planning, leadership and worker recruitment, retention and wellbeing are provided. Finally, theories of knowledge and innovation dissemination, learning models and theories, and emerging use of technology are examined.