Australia’s rural community mental health (CMH) services face serious workforce shortages. Research specifically investigating factors impacting retention of rural-based CMH health professionals is scarce. This study (part of a larger rural nursing and allied health workforce retention study) identified factors affecting the job satisfaction of Aboriginal mental health workers (AMHWs) working in CMH services in rural NSW.

AMHWs are either trainees or graduates of NSW Health’s Aboriginal Mental Health Worker Training Program. This program was introduced in 2008 in response to the Council of Australian Governments’ ‘Closing the Gap’ framework, and is one of NSW Health’s strategies for developing an Aboriginal clinical workforce.

Dr Cath Cosgrove

While other health professionals working in CMH have undertaken a university degree in an ‘eligible’ health profession, the career pathway for AMHWs differs. AMHWs are recruited as trainees at the Local Health District level involving a three-year traineeship under the supervision of senior CMH staff while also undertaking a Bachelor Health Sciences (Mental Health).  On successful completion of the qualification, AMHWs are then contracted into a full-time case management position in the CMH service.

Five AMHWs (3 qualified and 2 trainees) working for NSW Health in rural and remote CMH services, participated in in-depth, semi-structured interviews to build understanding of how employment, professional and rural-living factors affected their intention to stay or leave their CMH positions.

The study found that AMHWs commonly experience low levels of job-satisfaction, especially while working as trainees. Of particular concern was the Health Sciences qualification not translating into NSW Health’s ‘professionalised’ workplace, as well as having negative effects with respect to remuneration and career opportunities within NSW Health. In addition, role challenges involving cultural differences and managing additional professional and personal boundaries were found to negatively affect job-satisfaction.

In many respects the AMHW program is a very praiseworthy workforce strategy but to maximise its effectiveness the issues identified need to be rectified. NSW Health could do this by making changes to the degree qualification obtained under the training program, as well as raising the level of understanding about the program, and Indigenous cultural awareness generally among CMH staff and NSW Health management.

By Dr Cath Cosgrave | Research Fellow – Nursing and Allied Health Rural Workforce | Department of Rural Health

Faculty of Medicine, Dentistry and Health Sciences | The University of Melbourne