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Victoria's Mental Health Services
Careers in Mental Health

Occupations in Mental Health

Page content: Nursing | Psychiatry | Psychology | Social work | Occupational Therapy | Support Work | Consumer & carer consultants | Working with Aboriginal communities

Nursing

Mental health nursing is the largest profession in the Victorian mental health system. It's a specialised field that focuses on biopsychosocial health assessment and meeting the mental health needs of consumers. Mental health nurses are trained in theoretical aspects of mental and physical illness and work with consumers with mental health problems and their families, carers and significant others.

Nursing in Victoria

All nurses who practise in Victoria must be registered with the Nurses Board of Victoria (NBV). Nurses are registered as either a division 1, 2 or 3 on the nursing register. Division 1 includes:

  • graduates from accredited university courses
  • midwives
  • maternal and child health nurses
  • psychiatric nurses
  • nurse practitioners (by endorsement).

Division 2 includes graduates from accredited courses in the vocation, education and training sector (VET). They work under the supervision of a division 1 or 3 nurse.

Division 3 (now closed) includes nurses who undertook a three-year hospital-based psychiatric nursing certificate or who completed the Bachelor of Psychiatric Nursing, which was available in the early 1990s.

The skills of a mental health nurse
The primary tool of a mental health nurse is a good knowledge of human bodily systems as they relate to mental illness and psychotropic medications. Their main attribute is the ability to build rapport and a therapeutic relationship to understand the consumer's life experience and how they interact with their environment. The primary skill of a mental health nurse is promoting biopsychosocial wellbeing and recovery and a sense of connectedness through family and social inclusion.

The role of a mental health nurse
Mental health nurses monitor the biological dimensions of mental illness through administering medication and observing behaviour. Mental health nurses advocate for and protect consumers' rights and provide psycho education and support to consumers, families, carers and the community.

Interventions commonly undertaken include:

  • mental health assessments
  • ongoing monitoring of a consumer's mental and physical health
  • individual and family counselling, education and support
  • psychological therapies
  • care coordination/management
  • administering and monitoring medication
  • active advocacy
  • linking consumers under their care with other relevant service providers if appropriate.

Mental health nurses recognise the need for flexibility, adaptability, responsiveness and sensitivity as they continually shape their practice to the dynamically changing needs of the consumer, family, significant others and the community.

Work settings
Mental health nurses can work in a broad range of diverse roles and places across both public and private services, including in:

  • child, adolescent, adult and aged acute inpatient units
  • residential and non-residential rehabilitation programs
  • community-based teams that provide a crisis response, assertive outreach and continuing care
  • emergency departments
  • the forensic and justice system
  • the primary care sector and community health centres
  • training, education and research.

For further information regarding nursing, including mental health, visit the Nursing Victoria website.

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Psychiatry

Psychiatrists are medically qualified doctors who look after people with mental health problems, such as depression, schizophrenia, eating disorders, anxieties, phobias, and drug and alcohol abuse. Psychiatrists work in a number of different places including hospitals, people's own homes, residential centres for older people and people with special needs, as well as in prisons.

There is considerable competition for places at medical school. Successful candidates will need:

  • excellent academic qualifications
  • enthusiasm with good interpersonal skills
  • a wide range of outside interests
  • some interest in a caring profession.

Qualifying as a psychiatrist

Psychiatrists first train as doctors and undertake six years of university study, including some experience in psychiatry, to gain their basic medical qualification. They then work as interns in a general hospital for a further 12 months to become a registered medical practitioner, followed by at least another year as a resident medical officer.

A panel of doctors then interviews each applicant for the Psychiatric Training Program. Training in psychiatry requires mandatory supervision by experienced, qualified psychiatrists. Rigorous examinations are conducted throughout their training during which their experience and competence are tested. Training takes a minimum of five years working under supervision in a range of settings.

Psychiatrists hold a specialist qualification awarded by the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and may work as clinicians or non-clinicians across the public and/or private sectors of Victoria's mental health system.

A variety of work options

Psychiatry is an excellent career choice for anyone interested in how the mind works, and for someone who enjoys working as part of a team. Psychiatrists work across a person's lifespan in a number of specialist areas, including child and adolescent psychiatry (working with young people up to school-leaving age), forensic psychiatry (working with people with mental illness who commit crimes), psychotherapy (using 'talking treatments' rather than prescribing medication, to help people) and the psychiatry of learning disability (what used to be called ‘mental handicap').

Many psychiatrists have a predominantly private practice. Others work mainly in hospitals, prisons or a variety of public health facilities.

Some psychiatrists work in more than one area, such as combining part-time work in a public hospital with a private practice. Psychiatrists are also involved in a broad range of community issues and organisations, and are often called upon to assist both government and non-government agencies to help develop mental health policies and services.

For further information regarding working as a psychiatrist, visit the RANZCP website.

Psychology

Psychologists are health professionals who have undergone a thorough program of undergraduate and postgraduate education and supervised training in internal thinking and emotional processes. They learn about diagnosis, assessment, testing and treatment planning, and conduct and apply research to reduce distress and behavioural and psychological problems to promote good mental health and rational behaviour in individuals and groups.

Some psychologists undertake additional specialist training in specific areas, including family and relationships therapy, depression and grief, sexual therapy, child psychology and education, and techniques like cognitive behavioural therapy (CBT).

Becoming a psychologist
To register as a probationary psychologist in Victoria (which is the first step to becoming a psychologist) requires four years of approved study in psychology. This normally comprises a bachelor's degree with a three-year accredited major in psychology, followed by an accredited fourth-year course in psychology.

Currently, psychologists must be registered with the Psychologists Registration Board of Victoria. From 1 July 2010 psychologists across Australia must be registered with the Psychology Board of Australia, a single national registration scheme that will allow psychologists to work in any state or territory across Australia. The board was established under the Health Practitioner Regulation (Administrative Arrangements) Act 2009.

Specialist psychologists
Clinical psychologists specialise in assessing and diagnosing major mental illnesses and psychological problems. They have a minimum of six years' university training, including approved postgraduate clinical studies and placements in psychiatric settings. Clinical psychologists complete all the same basic training as other specialist psychologists but undertake a master's/doctorate in clinical psychology in order to be eligible for membership of the APS College of Clinical Psychologists.

Clinical psychologists hold positions in private practice, hospitals, universities, general medical practices, community health centres and mental health services. They work with infants, children, adolescents and adults, and are also involved in designing and implementing a wide range of prevention and mental health promotion programs.

Clinical neuropsychologists specialise in assessing and diagnosing brain impairment and how this affects thinking skills, emotions, behaviour and personality. They are also involved in rehabilitating and managing the effects of brain impairment and often work with other allied health professionals. Most clinical neuropsychologists are employed in major hospitals, rehabilitation centers, psychiatric services and private practice.

Forensic psychologists work with people who have committed crimes, applying psychological knowledge to assessment, intervention and research in the forensic mental health system.

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Social work

Social work focuses on the social aspects of mental health problems. Social workers use a biopsychosocial model to inform their understanding of mental illness and to guide their practice.

Becoming a social worker
A social work degree is typically four years’ full-time study or part-time equivalent in an accredited social work course. In recent times some universities have introduced a qualifying master’s degree as an entry-level qualification. The Australian Association of Social Workers (AASW) accredits social workers with specialist qualifications and training in mental health to work as service providers in the Commonwealth-supported Enhanced Primary Care for Mental Health Workers scheme and the Better Access to Mental Health Care initiative.

Social workers are not currently required to be registered; however, most employers will require prospective applicants to be eligible for membership of the AASW.

The work of a social worker
Social workers are the only mental health workers with social-science training that supports a unique sociological perspective and empowerment ethic. This encompasses a wide range of theoretical perspectives and methods of intervention, underpinned by participative approaches, anti-oppressive practice and the principles of social inclusion. Within a multidisciplinary practice they look beyond the person's mental distress to important dimensions such as social inclusion. They also look at mental health consequences of abuse and discrimination including stigma arising from a mental health diagnosis, and relationships with family and informal carers.

Social workers are employed in treatment and rehabilitation services across the public, private and non-government mental health service sectors, including primary care. They promote recovery and restore individual, family and community wellbeing to help individuals regain control over their lives, and to advance the principles of social justice.

This person-centred yet holistic approach often engages mental health social workers in complex cases, such as personality disorder, and in equally complex interventions with people who have mental health problems. For social workers, this approach includes effectively managing the dilemmas that can exist between enabling and protecting people who experience mental distress. It includes identifying children in need and at risk, safeguarding their welfare and assessing parental capacity as well as addressing the mental health problems of adults and their carers, who may also be children or young people.

Occupational Therapy

Occupational therapists (OTs) work with people of all ages who have a variety of conditions caused by injury or illness, psychological or emotional difficulties, developmental delay or the effects of ageing. They help people improve their everyday functional abilities and enable independence, wellbeing and quality of life.

The work of a Occupational Therapist
Occupational therapists (OTs) work with people of all ages who have a variety of conditions caused by injury or illness, psychological or emotional difficulties, developmental delay or the effects of ageing. They help people improve their everyday functional abilities and enable independence, wellbeing and quality of life.

OTs work across the whole spectrum of mental health services, including inpatient and community settings, and in hospital and non-government organisations, providing services for children, adolescents and adults.

Ideally, OTs have:

  • patience and a flexible attitude
  • practical, innovative and observational skills
  • problem-solving skills
  • good interpersonal and communication skills
  • the ability to work both as part of a team and independently.

OTs will have the opportunity to specialise in a variety of areas within mental health, such as:

  • individual and group psychotherapy
  • crisis assessment and intervention
  • family therapy
  • inpatient and community forensic services
  • specialised occupational therapy assessment and intervention that facilitates a consumer's occupational performance (living skills, education, work and leisure) in the context of mental illness such as functional assessment, sensory processing
  • psychosocial rehabilitation
  • early intervention
  • providing specialist consultation to other service providers
  • supervision and leadership.

The great majority of mental health OTs work in community-based positions involving case management. They primarily work with the person who has a mental illness, specialising in assessing how their mental illness impacts on their ability to function in their everyday occupations and roles. They also focus on how a person's lifestyle can support their mental health and improve their quality of life.

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Support Work

Some mental health professionals move into support work in mutual support and self-help (MSSH) services. These services provide information, support and assistance to families, carers and people dealing with mental illness. This can involve sharing experiences and coping strategies, providing information and referral services, and promoting community awareness. The specialist, statewide MSSH workforce includes service managers, volunteer coordinators, support workers and administrative support staff. Their role is to address mental health conditions within a developmental approach. They promote mutual support from others living with mental illness, as well as encouraging consumers to be active in their own recovery.

Caring for a relative or friend with a serious mental illness presents carers with many challenges. Carer support and resource workers (mental health) form an integral part of the model of the generalist carer service system that supports carers in this role. They assist services by providing information resources, acting as community education and referral pathways and delivering carer support. Support organisations include:

Consumer & carer consultants

Consumer consultants are now an integral part of Victoria's clinical mental health services. They are employed in adult area mental health services and work to ensure that a consumer perspective is included in all aspects of mental health service planning, delivery and evaluation.

Their role is to improve mental health services' responsiveness to consumers needs. Some consumer consultants have extended their scope to develop collaborative relations with aged persons' mental health services, child and adolescent mental health services and PDRS services.

Carer consultants are a relatively recent addition to clinical mental health services. They have largely been developed in recognition of the important contribution carers can make to treatment planning and consumer outcomes. Their role is to provide support, information and referral to families/carers and to work collaboratively with area mental health services to develop improved service responsiveness to the needs of families and carers.

The National Mental Health Consumer and Carer Forum is the combined national voice for consumers and carers participating in the development of mental health policy and sector development in Australia.

Working with Aboriginal communities

The Victorian Government funds Koori mental health liaison officers (KMHLOs), who are based in Victorian Aboriginal Community Controlled Health Organisations. These officers play a vital role in assisting rural clinical mental health services to provide culturally appropriate services, develop culturally sensitive policy and provide practical support to Aboriginal people engaged in these services.

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Last updated: 16 February, 2011
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