NZAC workforce survey crucial to counselling profession

Like many an industry, the counselling profession is at a crossroads.

There are a range of trends – more people (especially youths) are presenting with increasingly complex issues, and our workforce is ageing – that the NZ Association of Counsellors (NZAC) need to prepare for over the next decade.

Therefore, the NZAC Executive has decided to develop a workforce survey to help them better understand the profile of the current and projected counselling workforce.

A questionnaire has been compiled, which NZAC believes covers the key areas on which they require feedback, and will be shared soon with the roughly 1,000 members of New Zealand Christian Counsellors Association and other associations, as well as our 3,000 members.

That information will be of immense value to NZAC and other professional counselling associations, and the Government, including District Health Boards and the Ministries of Health, Justice and Education.

This information will contribute to ensuring the Government can make adequate and appropriate provision for our future mental health workforce.

Counsellor education programmes will use this survey information for recruitment and preparation of counselling graduates to meet workforce needs.

The survey will also gather information about counsellors’ workplace challenges, members’ current specialist knowledge, and professional development needs.

The questions about burnout are important to guide the development of a more sustainable profession. The information on planned retirement is essential for future workforce planning.

It is extremely important that NZAC has a high level of response to the survey to ensure robust and influential results, so President Christine Macfarlane implores members to take the time to complete it once received.

“This undertaking is a significant one for our profession and the Association, and will set the direction of travel we will need to take over the next five to 10 years to ensure there are enough well trained and qualified counsellors in the areas that require them.”

The launch of the long-term pathway to mental wellbeing

The NZ Association of Counsellors welcomes the Government’s step change in its mental wellbeing approach, by strengthening and utilising the already great work being done by community organisations.

Announced in September, the Government’s newest long-term pathway for transforming New Zealand’s approach to mental wellbeing – Kia Manawanui (the pathway) – sets out the government’s actions over the next 10 years.

Building on the agenda set by He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction (He Ara Oranga) published in 2018, the pathway sets out the direction of change needed to promote, protect, and strengthen mental health in Aotearoa.

By ensuring people and whānau have their basic needs met, the pathway aims to help strengthen individuals own mental wellbeing, and live in communities with diverse, well-integrated avenues for support when and where it is needed.

A central aspect of this long-term pathway is the Crown’s obligation to uphold Te Tiriti o Waitangi and protect and promote Māori mental wellbeing and equity.

The pathway recognises that Māori experience unfair and avoidable inequities in terms of mental wellbeing and intends that this pathway will address equity through ‘for Māori, by Māori’ approaches.

Therefore, the pathway  is centre around the vision of pae ora (healthy futures), drawing on Whakamaua: Māori Health Action Plan 2020–2025.

“We must think more broadly about how to support the whole population to stay well, while addressing inequities and ensuring appropriate and tailored support is available to those who need it,” the pathway states.

“This will involve drawing on the collective knowledge, strengths and efforts from a wide range of contributors to mental wellbeing – including communities; whānau, hapū and iwi; and individuals themselves – and providing multiple and scalable avenues of information and support to make sure we reach the whole population.”

The pathway’s mental wellbeing framework takes a holistic, population-based approach that requires the Government to focus on five key areas:

1. Build the social, cultural, environmental, and economical foundations for mental wellbeing.
2. Equip communities, whanau, and individuals to look after their mental wellbeing.
3. Foster community-led solutions.
4. Expand primary mental wellbeing support in communities.
5. Strengthen specialist services.

“Some of the most powerful steps that can be taken to improve mental wellbeing and address inequities lie outside of the mental health and addiction system,” the pathway states.

Meaning the government’s future approach will include addressing the wider determinants of negative mental wellbeing outcomes and inequities – including suicide risk.

Incorporating the government’s response to mental health and addiction needs with other policies and strategies – such as the Healthy Homes Initiative, Housing First, the Homelessness Action Plan and the Ara Poutama housing and reintegration initiative – will bring important benefits for physical and mental wellbeing.

While this sounds like a practical and comprehensive approach, NZAC President Christine Macfarlane says – that like most things – the devil is in the detail.

“For this pathway to have any significant and positive impact on the lives and mental wellbeing of New Zealanders, collaboration, coordination and communication of all government agencies with each other will be crucial.

“Too often, the left hand doesn’t speak to the right, and we see New Zealanders slip through the cracks.

“Nevertheless, supporting and strengthening the already amazing work done in communities by organisations that understand residents’ needs is a good move.

“And I welcome the Government’s willingness to promote mental wellbeing and to connect people with the support they need. But how they will ‘increase mental health, addiction and suicide prevention literacy, and supporting cross- sector and community workforces to identify and respond to the mental wellbeing needs of people they interact with’ remains to be seen.

“As we’ve said previously on numerous occasions: New Zealand already has a resource of well-trained, qualified, and regulated counsellors that would be able to support Kiwis’ mental health.

“So, when the pathway states that ‘we need to design, resource and support our specialist services adequately’, I would encourage the Government to consider the workforce already available today and fund more public access to counselling services.

“The public demand is for existing counselling services that offer more intense and longer-term therapy. Research also shows that professional counselling, provided by trained and qualified practitioners, is an effective method of addressing both mild to moderate mental health concerns and more traumatic issues.”

Code red for humanity: What does this mean for NZAC?

Counselling doesn’t have a detrimental effect on the environment like the transport and energy sectors. Nevertheless, Des Casey says counsellors aren’t exempt – we are all in this together.

A counsellor of 35 years, Des’ work includes family therapy, relationship counselling, supervision and mediation.

The Nelson-based counsellor’s training, people skills, and wide experience provide an effective solution-oriented and empowering focus.

Yet, during the NZ Association of Counsellors’ Professional Development Symposium in July, Des highlighted climate change’s ‘code red’ and what it might mean for counsellors.

“My disquiet about the assault on nature has been around since the 80s and 90s, and with it a wrestling within me about the work/nature connection,” he says.

“When I first started thinking about this, it seemed very clear what other work occupations needed to do. If I was a farmer, I would have synthetic nitrates, fossil fuels, and streams in my sights.

“If [I was] in the fishing industry, bottom line trawling, nets, sea birds, and dolphins.

“Business, politics, trades and corporates – seemed clear what needed to be done in those spaces. But I was a counsellor – counselling didn’t seem to fit. Counselling wasn’t having a detrimental effect on the environment, on climate, on other species.

“Was I exempt? Afraid not. We are all in this together – we are in a time when the human relationship with nature, how we perceive and act towards the natural world, has never been under such intense and scary scrutiny. Every one of us, in our working lives, must fit in here somewhere, somehow.”

Des argues that counsellors’ responsibilities to the natural world fall under their commitment to Kaitiakitanga – the commitment to caring for people, the land, fresh water, sea and air, and all that dwells there.

As counsellors focus on this commitment with people each day of their working lives, Des says today’s world challenges us to do likewise with nature, to connect with the natural world as we connect with our own species.

“My emphasis is on the meaning environmental developments might have on our work and how we might respond.”

Des believes there are three areas counsellors should consider.

Firstly, counsellors might consider how they include nature and its processes in what they do, to include an ecological context to a counsellor’s work just as gender and culture (Te Tiriti o Waitangi) contexts were eventually included.

Secondly, Des thinks it is imperative that the Association and its member become part of the widespread consciousness to address the natural world’s woes, as our relationship with it is crucial.

And lastly, he challenges NZAC to publicly question or support political, business, and economic institutions when addressing the damaging ways society is structured and managed.

“There is something indigenous in the way we need to think. That innate linking, being part of, never separate from but connected to nature and its operations, its processes, its needs,” Des says.

“It doesn’t mean leaving the modern world; it doesn’t necessarily mean not doing what we already do. It means connection with and realisation of our being part of, a member of, the natural world.”

To read Des Casey’s presentation in full, click here.

New research shows link between conversion practices and negative mental health for trans and non-binary people

New findings published from a national survey led by University of Waikato researchers has found that trans and non-binary people living in Aotearoa New Zealand who have experienced gender identity conversion practices are more likely to have worse mental health.

The findings showed they experienced higher rates of psychological distress (including depression and anxiety), and were over two times more likely to report non-suicidal self-injury and suicidal thoughts, and over three times more likely to report a suicide attempt.

The Aotearoa New Zealand Trans and Non-Binary Health Survey, Counting Ourselves, earlier reported that almost one in five trans or non-binary participants surveyed had experienced a health professional trying to stop them being trans or non-binary.

Further research just published in the international journal, Psychology of Sexual Orientation and Gender Diversity, highlights that such gender identity conversion practices may have adverse mental health impacts, says Dr Jaimie Veale, Senior Lecturer in Psychology and Director of the Trans Health Research Lab at the University of Waikato.

“Being told that something as core to your being as your gender is wrong could have serious impacts on a person’s health and wellbeing,” says Dr Veale.

The latest findings come as government considers submissions on the Conversion Practices Prohibition Legislation Bill, designed to ban conversion therapy in New Zealand, a practice already illegal in some parts of the world.

Dr Veale and Senior Researcher, Jack Byrne, have recently presented the Trans Health Research Lab’s latest findings to the Justice Committee hearing these submissions.

“Our findings suggest that conversion practices could harm trans and non-binary people’s mental health. Action is needed to prevent any harm caused by conversion practices wherever it occurs, including within health, religious, family and community settings,” says Dr Veale.

Earlier findings released from Counting Ourselves showed the difference that family rejection or support made.

While nine per cent of those with family support had attempted suicide this almost doubled to 17 per cent of trans and non-binary people who had family that were unsupportive or very unsupportive.

Data in the Trans Health Research Lab’s latest published article reinforce this concern. Trans and non-binary people who had experienced family rejection were more likely to say they had been exposed to conversion practices.

“This suggests that family rejection, and the harm it causes, may involve family taking their trans or non-binary child to a professional who performs conversion practices,” says Mr Byrne.

“Families and whānau need information and resources to feel confident to support their trans and non-binary family members.”

People with mental health or addiction issues at higher risk of dying from COVID-19

People who experience of mental health and addiction issues are at higher risk on average of contracting COVID-19 and poorer health outcomes once infected with COVID-19.

That is the key finding of a study produced by Equally Well Te Pou (Te Pou), s group of people and organisations with the common goal of achieving physical health equity for people who experience mental health and addiction issues.

While it was released earlier this year, the report – titled The evidence on COVID-19 risk for people experiencing mental health and addiction issues – is strong evidence to support adults with mental health and addiction issues being prioritised for COVID-19 vaccination.

Te Pou undertook a literature scan to inform its study’s key finding, concluding there is an independent association between the experience of mental health and addiction issues and a higher likelihood of infection with, and poor outcomes from, COVID-19.

“It is clear from this evidence that if vaccination prioritisation is based simply on the physical health conditions that this group typically experience, this would exacerbate existing health inequities,” the study states.

“This evidence update therefore helps inform the Equally Well collaborative and others to take action, increase awareness, and advocate for the need to include people with experience of mental health and addiction issues as a priority group for vaccination rollout.”

Overseas researchers are highlighting the importance of including people with experience of mental health and addiction issues as a priority group for COVID-19 vaccination.

Countries like the UK, Germany, Ireland, Denmark, and the Netherlands have moved to include this group in their COVID-19 vaccination prioritisation advice.

New Zealand began its COVID-19 vaccination rollout in February 2021. The Vaccine Sequencing Framework sets out who will be vaccinated first, and when, in relation to different scenarios.

The framework prioritises ‘people with relevant underlying conditions’ as many health conditions are considered risk factors for contracting COVID-19 and experiencing poorer health outcomes.

What is clear from several large UK and US studies is that people meeting diagnostic criteria for a mental health or addiction issue in the past year (including first diagnosis), experiencing multiple mental health or addiction issues, or accessing inpatient services, have a higher risk of COVID-19 infection.

In fact, a UK cohort study of people aged 40 to 69 indicates the risk of COVID-19 is twice as high for people meeting diagnostic criteria for a mental health or substance use issue in the past year, or three or more diagnoses. These risks appear even higher for people accessing inpatient services.

Overseas research suggests the risk of dying from COVID-19 may be up to twice as high for people with experience of mental health and addiction issues, and even higher for certain diagnoses and people with more complex needs.

In New Zealand, Māori experience higher rates of mental health and addiction issues compared to non-Māori, as well as other compounding COVID-19 risk factors such as socioeconomic deprivation and physical health comorbidities.

While New Zealand’s death rates from COVID-19 have been comparatively low compared to other countries, a Ministry of Business, Innovation and Employment funded study showed an increased risk of hospitalisation and death from COVID-19 infection for Māori people in New Zealand.

The risk of hospitalisation from COVID-19 is two to three times higher for Māori and Pacific peoples, compared to other ethnic groups.

NZAC Te Ahi Kaa Gay Puketapu-Andrews says one of the most effective tools to mitigate risks to Māori and Pasifika are communication relationships with whanau, iwi and community groups.

“These trusted relationships, and the communication that goes with them, create a safe place with which to support individuals and establish collective ties – ensure that the health and wellbeing of all individuals and groups are protected and enhanced.

“These relationships have also facilitated people to step into that vaccination space.

“So, it stands to reason that a similar holistic approach for people with mental health and addiction issues would also go some way to ensuring their safety.

“That means strengthening those trusted relationships – whether that is with friends, family or community organisations – and taking a breather from the mainstream and social media, which can catastrophise a situation or promote unreliable information.”

Counselling professionals are also a valuable tool for people to utilise, Gay says.

“Many counsellors would know how to have difficult conversations with people that allow them to make the right decision for themselves. That’s our job.

“And I think that is very applicable around encouraging people to having conversations that support them to be well informed about getting vaccinated.

“So, I will be very reticent about telling someone they should get vaccinated, despite my personal views. But I must ensure that they feel comfortable that, when they make decision, it is the right one for them.”