Mental health roles

What mental health roles can I work in?

The consumer, peer support, lived experience (CPSLE), and whānau workforce includes all roles that require personal lived experience of mental health and/or addiction challenges or supporting whānau. This includes roles such as peer support workers, peer navigators, and consumer advisors, where lived experience is a primary and central part of their mahi; as well as whānau navigators and Whānau Ora kaimahi. Nearly all CPSLE and whānau roles work in health funded adult mental health and addiction services, and most are employed by NGOs. There is a growing number of CPSLE and whānau workforce in more health settings like child and youth services, emergency departments, and other health funded services including housing and homelessness services and prison services by Ara Poutama Aotearoa | Department of Corrections.

Kaimahi in the CPSLE and whānau workforces use the knowledge, skills, and insights they have gained from personal experiences of navigating challenges, services, and recovery to support tāngata whai ora going through similar experiences. People who have supported their own whānau in recovery can also use that experience to support others. CPSLE and whānau workers support people by offering guidance, helping them work towards their personal wellbeing and recovery goals, and enhancing hope, skills, and self-determination.

Formal qualifications aren’t always needed to start working in CPSLE and whānau workforce roles, but training is essential once entering this space. There are many training options available to enhance people’s knowledge and skills in using their lived experience to support others’ wellbeing.

For more information, resources, and news about Aotearoa New Zealand’s CPSLE and whānau workforce visit the Te Pou website.

Support workers are the largest workforce group in Aotearoa New Zealand’s health funded mental health and addiction sector.1 This role group includes health coaches and other roles that do not require a professional registration. Two in three support workers are employed in mental health and addiction NGOs, and there is a growing number in Health New Zealand | Te Whatu Ora providers. Support work primarily involves helping tāngata whai ora to achieve their health and wellbeing goals, building trusting relationships, providing advice and practical assistance, and engaging with whānau. Support workers do their mahi in a range of settings including the communities and homes of tāngata whai ora, healthcare and residential settings, and schools and workplaces. Learn more about the mahi support workers do from a collection of short films by Te Pou.

Similar roles include nursing and allied health assistant roles which are likely to work inside mental health hospital settings and may also require a Level 4 qualification.

Cultural workers use their knowledge, skills, experiences of being a member of their cultural group, and access to cultural resources to support tāngata whai ora whānau, and communities to promote holistic wellness and recovery.³ Cultural workers can support tāngata whai ora from any background while also using specific cultural knowledge to support those who share their own cultural background. In the health sector, there are established cultural worker positions for Māori, Pacific and Asian peoples, and refugees.⁵

Cultural workers can be known by many role titles including mataora and taurawhiri. Role titles can also be specific to organisations, whānau, hapū, and iwi or other communities to reflect their context and the mahi they do. Cultural worker roles may also be registered health professionals depending on the mahi required.^3,4

In mental health settings, cultural workers’ roles and responsibilities can look different across organisations and places, reflecting the unique needs of where they work and who they work with. Broadly, some of the mahi they do can include cultural assessments, wellbeing support, advocacy, shared decision-making support, and enhancing cultural practice within organisations. Māori cultural workers can support whakawhanaungatanga, whānau hui, and access to tikanga Māori (eg waiata, kapa haka, rongoā). Building and maintaining community relationships are important parts of cultural work, such as connecting tāngata whai ora and whānau with relevant services, communities, and kaumātua or other cultural leaders.^3,4 Because cultural work is so diverse, it is a good idea to check with specific organisations and job listings to better understand what the day-to-day mahi involves.

Importantly, cultural workers aren’t expected to know everything about the culture; learning and developing cultural knowledge, skills, and identity can be a lifelong journey for many people. Often, cultural work aims to harness the knowledge and strengths of individual kaimahi to address a specific service or community need. For example, a kaimahi may be highly skilled in rongoā but still be developing their te reo Māori fluency.

There is no single education or training pathway to becoming a cultural worker, but the understanding and application of cultural knowledge and skills are central to these roles. A common pathway is to train and work in a different area of practice (eg support work, social work), then stepping into a cultural role. While people can apply for cultural roles themselves, they may also be invited into a cultural role as an acknowledgement of what they can contribute to their communities, and to utilise their skills to address specific needs.

Nurses are registered professionals who draw on clinical, scientific, relational, and cultural skills to provide holistic strengths-based support for tāngata whai ora and whānau. They work within interprofessional teams and build strong therapeutic relationships with tāngata whai ora and whānau to enhance health and wellbeing. Nursing is underpinned by key principles including commitment to Māori health, cultural safety, whanaungatanga (partnership and communication), pūkengatanga and knowledge-informed practice, and mana hautū (professional accountability and responsibility).⁶

Nurses are the second largest role group in mental health and addiction services. Most are employed by Health New Zealand | Te Whatu Ora providers in inpatient and community settings. They can also can work in other settings including primary and secondary care, social and community services, aged care, child health services, and Ara Poutama Aotearoa | Department of Corrections settings.

To work as a nurse in a mental health and/or addiction service, you typically need to specialise as a mental health/addiction nurse or be a registered nurse on the pathway towards this specialty.

You may also complete an accredited Level 5 programme to become an enrolled nurse. Enrolled nurses work alongside other nurses or registered health practitioners to provide equitable support for tāngata whai ora, whānau, and communities. More information about enrolled nurses’ mahi and how to become an enrolled nurse is available on NCNZ’s website.

Nursing practice extends beyond providing direct support in clinical and community settings; you can also apply nursing skills and knowledge in administration, management, education, research, and advisory roles within mental health and addiction.

Further nursing career pathways include the nurse practitioner and nurse prescriber roles. Working in these roles requires significant nursing practice experience and additional training and qualifications. More information on these pathways, registration, and nursing scopes of practice is available on NCNZ’s website.

Social workers are registered professionals who help to restore and strengthen people’s capacity to work through difficult situations, enhance wellbeing, and address broader determinants of health and wellbeing including poverty, inequity, discrimination, and violence.

Social workers do their mahi and collaborate across a wide range of settings including kaupapa Māori organisations, marae, healthcare, schools, homes, Ara Poutama, youth, and residential services. In health funded mental health and addiction services, social workers are mostly employed by Health New Zealand | Te Whatu Ora providers.

For more information on becoming a social worker in Aotearoa New Zealand, see SWRB’s website.

Counsellors are registered professionals who provide safe and supportive environments for tāngata whai ora to identify, explore, and find ways to improve their mental health and wellbeing. Counsellors use a range of approaches and strategies to enhance people’s coping and communication skills, sense of self-efficacy and awareness, and capacity to tackle the individual, social, and broader challenges they may be facing. This mahi involves building trusting, respectful, and non-judgemental therapeutic relationships in which positive change can happen. Counsellors can work in a range of mental health settings including primary care, NGOs, hospitals, and private practice. Registered counsellors with Te Whatu Ora accreditation can also work as HIPs to provide mental health and addiction support for tāngata whai ora in primary care settings.

Occupational therapists are registered professionals who work with tāngata whai ora to build a life they value by enabling their participation and inclusion in society. This involves enhancing their wellbeing and participation in the meaningful activities and tasks of everyday life that they want, need, or are expected to do, including engaging with whānau and communities that matter to them. Occupational therapists’ mahi aims to address a range of barriers (including cultural, educational, social, and health) to social and community participation. Occupational therapists do their mahi in settings including community services, healthcare services (including GPs, hospitals, and outpatient settings), Ara Poutama, schools, and hospices.

For more information about becoming an occupational therapist in Aotearoa New Zealand, see OTBNZ’s website.

Psychologists assess, treat, and work to prevent a range of mental health and wellbeing challenges that can affect people’s lives. Psychologists can provide a wide range of support for tāngata whai ora with managing everyday problems and distress, specific mental health and wellbeing challenges, enhancing whānau and social relationships, and participation in work and study. Psychologists can work in a range of settings including NGOs and Health New Zealand | Te Whatu Ora services, mental health and addiction services, hospitals, schools and universities, Ara Poutama, and private clinics. In health funded mental health and addiction services, most psychologists are employed by Health New Zealand | Te Whatu Ora providers.

Psychologists provide specialist support in specific areas that they are qualified and trained in, which are reflected in their scopes of practice. Each scope of practice has a unique focus and requires specific qualifications and experience. The main scopes of practice in specialist mental health and addiction services are general and clinical psychologists. Counselling psychologists may also work in specialist services but typically work in other settings such as primary care, university counselling, and private practice.

Other psychologist scopes of practice that do not typically work in mental health and addiction services include educational psychologists and neuropsychologists.

On the pathway towards becoming a registered psychologist, you may work under the intern or trainee psychologist scope of practice. These are not registered roles; intern psychologists are enrolled in an accredited programme and practising under supervision, and trainee psychologists are employed and enrolled in an in-house training programme (such as with Ara Poutama).

For more information about becoming a psychologist in Aotearoa New Zealand, visit NZPB’s website.