Organisational Views of the Mental Health 

Support Worker Role and Function.

 

Barnaby D. M. Pace MNZPsS, Ass.MNZCMHN

BSocSc(Hons), MSocSc(Hons), PGDipCBT, PGDipEd(AdEd)

 Academic – Mental Health Support

 

Citation:
Pace, B.D.M. (2009). Organisational views of the Mental Health Support Worker role and function. 
International Journal of Psychosocial Rehabilitation. Vol 14(1).  29-33

Contact: Email Barnaby.Pace@wintec.ac.nz

Keywords: Mental Health Support Work, Residential and Community Support Services. Organisation, New Zealand.

Introduction
The role of a mental health support worker is not clearly defined and even within their job title ‘support worker’ there is ambiguity surrounding the role (Gallaway & Smith, 2005). This lack of definition leads to support workers performing numerous tasks and functions outside their job descriptions (Pace, 2009). These deviations can be attributed to a number of factors including the shortage of health staff and increasing demands for services (Baldwin, Roberts, Fitzpatrick, White, & Cowan, 2003).

Recently published research (Pace, 2009) investigated how support workers perceived their role within the mental health sector in order for the group to develop a sense of ‘professional’ self. The research involved a series of semi-structured interviews to explore how New Zealand Mental Health Support Workers perceived their role. The findings suggested a range of duties, including developing and maintaining therapeutic relationships, working alongside service users, community reintegration and administrative tasks.  The discussion which followed suggested further exploration into how health professionals viewed support workers and how best the different disciplines could compliment one another. What was not considered was how mental health and support organisations viewed the role and function of mental health support workers. As a continuation of the line of investigation in order to provide parameters for mental health support workers, the current investigation sought to identify the key duties of support workers as perceived from an organisational/employer perceptive. 

Method
Selection criterion used for the current research stated that the agencies provided mental health / psychiatric recovery and rehabilitation services, which employees paraprofessionals in the role of support workers. Six organisations meeting this criterion from the Waikato region in New Zealand agreed to participate in the research project. The sample comprised of four community-based non-government organisations (NGO’s), one clinical-based government funded agency, and a Kaupapa Maori-based NGO. Kaupapa Maori[1] services are design to cater for the specific needs of Maori[2] clients. 

A thematic analysis (Braun & Clarke, 2006) was conducted for eight Community Mental Health Support Worker job descriptions. Common themes in role, responsibility and function were identified and subsequently divided into three fields: 1. Roles and responsibilities, 2. Skills and Knowledge, and 3. Qualifications. The organisations values and mission statements were collected and compared to the content of the job descriptions to determine the principle focus of the organisation: clinical, or community/whanau-based. Statistical analysis was conducted to determine the relative strength of the Role/Responsibilities, Skills and Knowledge, and Qualifications required across the mental health organisations examined.

Results
The results indicted that the support worker role, from an organisational perceptive, comprises of eight commonly occurring roles, and seven key skills (Table 1). Key responsibilities indicated across service types included; 1. The development and subsequent maintenance of the therapeutic relationship with the identified client group. 2. The ability to meet key performance indicators as set by the agencies. 3. To advocate on behalf of the client group and offer support as required. 4. To be able to work as part of a team, and 5. To adhere to Health and Safety legislation and organisational policy. Supervision was also identified as a requirement of support workers for five of the six organisations. However, the roles and responsibilities required were not consistent across the organisations particularly with reference to support workers collecting client information and reporting accordingly. Likewise for liaising with other professional staff engaged in the client’s welfare. 

Required knowledge and skill revolved around two key aspects: Communication and Social and Cultural Needs. Each organisation clearly identified the need for support workers to be able to communicate effectively with those individuals in their care, as well as significant others such as family members. Alongside communication skills was the expectation that support workers will maintain a high level of client confidentiality. Secondly, each organisation referred to the need for support workers to have a working knowledge of the Treaty of Waitangi[3] and the ability to demonstrate cultural sensitivity and appropriate safety. Organisational and planning skills were also deemed as a significant skill set.  

The largest variation across the organisations related to the required level and type of minimum qualification. Three of the six agencies required the National Certificate in Mental Health (Level 4) as a minimum qualification, with two agencies stating no mental health or health care qualification was needed. The clinical based service required at least a National Diploma in Mental Health (level 6), a relatively new qualification to New Zealand. All agencies required support workers to have both a current drivers licence and first aid certificate.
 

Table 1. Results matrix

		Organisation 1*  (Community)	Organisation 2 (Clinical)	Organisation 3 (Community)	Organisation 4 (Community)	Organisation 5* (Kaupapa Maori)	Organisation 6 (Community)	Average
Role and  Responsibilities	Development Therapeutic Relationships	X	X	X	X	X	X	1
	Meet Key Performance Indicators	X	X	X	X	X	X	1
	Advocacy and Support	X	X	X	X	X	X	1
	Information gathering and reporting	X	X	X	-	-	X	0.66
	Supervision	X	X	X	-	X	X	0.83
	Liaison with clinical staff	X	X	X	-	-	X	0.66
	Teamwork	X	X	X	X	X	X	1
	Health and Safety	X	X	X	X	X	X	1
Skills and Knowledge	Communication and Listening Skills	X	X	X	X	X	X	1
	Planning and Organisational Skills	X	X	X	-	X	X	0.83
	Understanding of Social and Cultural Issues	X	X	X	X	X	X	1
	Analytical and Evaluation Skills	X	X	X	-	-	X	0.66
	Assessment Skills	X	X	X	-	-	X	0.66
	Culturally Sensitive	X	X	X	X	X	X	1
	Client Confidentiality	X	X	X	X	X	X	1
Qualification	National Certificate in Mental Health (Mental Health Support Work)	X	n/a	X	-	-	X	0.66
	National Diploma in Mental Health (Mental Health Support Work)	-	X	-	-	-	-	0.16
	First Aid Certificate	X	X	X	X	X	X	1
	Drivers Licence	X	X	X	X	X	X	1

* Two or more job descriptions reviewed

Areas which appear less consistent across services types revolved around what can be perceived as clinical-based duties, including gathering, assessing and reporting client-based information and liaising with clinical staff. Consideration of the skills required to carry out these duties lends itself to question the required qualification and level of competence to do so, indicating the boundary between professional and paraprofessional staff. This leads to the consideration of qualification required as indicated by mental health services. 

The greatest variation across the sample is seen with regards to the type and level of qualification required, ranging from no required qualification other than a current drivers licence and first aid certificate through to a National Diploma in Mental Health. The National Diploma in Mental Health being a pre-bachelors level qualification. This apparent lack of educational requirement surrounding mental health support work within New Zealand health care and rehabilitation providers is of potential concern, particularly considering the population support workers are working alongside. 

Further analysis of the data, comparisons to Pace (2009), and the inclusion of educational/training requirements allows for the development of a clear scope of practice for New Zealand mental health support work. Common occurring themes can be identified through the comparison of organisational job description and the support workers own perception of their roles and duties. Preliminary analysis shows fours commonalities between the findings given within the current paper and Pace (2009): the development and subsequent maintenance of the therapeutic relationships; support and advocacy on behalf of the client; effective communication skills; and the ability to create and maintain trust and confidentiality.

Based on research to date we can start to build an initial conceptualisation of the mental health support worker role, and define its scope of practice. Information shown through organisational support worker job descriptions indicates the clinical limitations of support worker practice suggesting support work to be a pre-clinical profession. Primary roles of support and advocacy as suggested within the job title form the principle function of support work based on the successful development of therapeutic relationships, with a strong emphasis on strengths-based practice and recovery principles. In order to further the development of the support workers function and scope of practice the initial conceptualisation needs to be tested and refined. Investigations of other mental health professionals and service user’s perceptions of mental health support worker, would add further vital information. Using these multiple views, the final conceptualisation will hold greater validity, with a higher probability of capturing the essence of the support worker role.

References

Baldwin, V., Roberts, J. D., Fitzpatrick, J. I., White, A., & Cowan, D. T. (2003). The role of the Support Worker in nursing homes: A consideration of key issues. Journal of Nursing Management, II, (6), 410-421.

Braun, V., & Clarke, V.  (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101.

Gallaway, J., & Smith, B. (2005). Meeting the education and training needs of rehabilitation support workers. International Journal of Therapy and Rehabilitation, 12, (5), 195-198.

 Pace, B. (2009). How New Zealand Community Mental Health Support Workers perceive their role. International Journal of Psychosocial Rehabilitation, 13, (2), 5-1