Factors affecting job satisfaction of Aboriginal mental health workers working in community mental health in rural and remote New South WalesCatherine Cosgrave A D , Myfanwy Maple B and Rafat Hussain C
A Department of Rural Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 49 Graham Street, Shepparton, Vic. 3630, Australia.
B School of Health, University of New England, Armidale, NSW 2350, Australia. Email: firstname.lastname@example.org
C ANU Medical School & Research School of Population Health, Centre for Research on Ageing, Health and Well-Being, The Australian National University, Acton, ACT 0200, Australia. Email: email@example.com
D Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - https://doi.org/10.1071/AH16128
Submitted: 12 June 2016 Accepted: 28 October 2016 Published online: 5 December 2016
Objective The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs).
Methods Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers’ decisions to stay or leave their CMH positions.
Results Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality.
Conclusions Policy and procedural changes to the AMHW training program may address the lower remuneration and limited career opportunities identified with regard to the Bachelor Health Sciences (Mental Health) qualification. Delivering training to increase levels of understanding about the AMHW training program, and cultural awareness generally, to CMH staff and NSW Health management may assist in addressing the negative team, organisational and cultural issues identified.
What is known about the topic? The Bachelor Health Sciences (Mental Health) qualification and traineeship pathway undertaken by AMHWs differs significantly from that of other health professionals working in NSW Health’s CMH services. The health workforce literature identifies that each health professional group has its own culture and specific values and that forming and maintaining a profession-specific identity is an extremely important aspect of job satisfaction for health workers.
What does the paper add? AMHWs working in rural and remote NSW CMH services commonly experience low levels of job satisfaction, especially while undertaking the embedded training program. Of particular concern is the health sciences qualification not translating into NSW Health’s ‘professionalised’ workplace, as well as having negative effects with regard to remuneration and career opportunities within NSW Health. In addition, role challenges involving cultural differences and managing additional professional and personal boundaries negatively affects the job satisfaction of AMHWs.
What are the implications for practice? The current structure of the AMHW training program creates workplace conditions that contribute to job dissatisfaction among rural and remote-based AMHWs. Many issues could be rectified by NSW Health 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.
References Australian Government Productivity Commission. Australia’s health workforce: productivity commission research report. Canberra: Commonwealth of Australia; 2005.
 Perkins D, Fuller J, Kelly BJ, Lewin TJ, Fitzgerald M, Coleman C, Inder KJ, Allan J, Arya D, Roberts R, Buss R. Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey. BMC Health Serv Res 2013; 13 157
| Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey.CrossRef |
 Australian Institute of Health and Welfare (AIHW). Mental health-related services provided in Australia: state and territory community mental health care services. Canberra: AIHW; 2014.
 Australian Institute of Health and Welfare (AIHW). Australia’s health 2014: snapshot-profile of Indigenous Australians. Canberra: AIHW; 2014.
 Health Workforce Australia (HWA). Mental health workforce planning data inventory. Adelaide: HWA; 2013.
 Cosgrave C, Hussain R, Maple M. Factors impacting on retention amongst community mental health clinicians working in rural Australia: a literature review. Adv Ment Health 2015; 13 58–71.
| Factors impacting on retention amongst community mental health clinicians working in rural Australia: a literature review.CrossRef |
 Buykx P, Humphreys J, Wakerman J, Pashen D. Systematic review of effective retention incentives for health workers in rural and remote areas: towards evidence-based policy. Aust J Rural Health 2010; 18 102–9.
| Systematic review of effective retention incentives for health workers in rural and remote areas: towards evidence-based policy.CrossRef |
 Keane S, Lincoln M, Smith T. Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions. BMC Health Serv Res 2012; 12 175
| Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions.CrossRef |
 World Health Organization (WHO). Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. Geneva: WHO; 2010.
 Department of Health NSW. Inquiry into health services for the psychiatrically ill and developmentally disabled. Sydney: Department of Health NSW; 1983.
 Australian Government Department of Health. National mental health strategy. 2014. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-strat [verified 23 April 2015].
 Lloyd C, King R, Bassett H. A survey of Australian mental health occupational therapists. Br J Occup Ther 2002; 65 88–96.
| A survey of Australian mental health occupational therapists.CrossRef |
 Roche M, Duffield C. Issues and challenges in the mental health workforce development. Contemp Nurse 2007; 25 94–103.
| Issues and challenges in the mental health workforce development.CrossRef |
 Lloyd C, King R, McKenna K. Generic versus specialist clinical work roles of occupational therapists and social workers in mental health. Aust N Z J Psychiatry 2004; 38 119–24.
| Generic versus specialist clinical work roles of occupational therapists and social workers in mental health.CrossRef |
 Fox V. Professional roles in community mental health practice: generalist versus specialist. Occup Ther Ment Health 2013; 29 3–9.
| Professional roles in community mental health practice: generalist versus specialist.CrossRef |
 Ashby S, Ryan S, Gray M, James C. Factors that influence the professional resilience of occupational therapists in mental health practice. Aust Occup Ther J 2013; 60 110–19.
| Factors that influence the professional resilience of occupational therapists in mental health practice.CrossRef |
 McNeil KA, Mitchell RJ, Parker V. Interprofessional practice and professional identity threat. Health Sociol Rev 2013; 22 291–307.
| Interprofessional practice and professional identity threat.CrossRef |
 Duckett S. Health workforce design for the 21st century. Aust Health Rev 2005; 29 201–10.
| Health workforce design for the 21st century.CrossRef |
 Lloyd C, Bassett H, King R. Mental health: how well are occupational therapists equipped for a changed practice environment? Aust Occup Ther J 2002; 49 163–6.
| Mental health: how well are occupational therapists equipped for a changed practice environment?CrossRef |
 Cosgrave C, Hussain R, Maple M. Retention challenge facing Australia’s rural community mental health services: service managers’ perspectives. Aust J Rural Health 2015; 23 272–6.
| Retention challenge facing Australia’s rural community mental health services: service managers’ perspectives.CrossRef |
 Lea J, Cruickshank M. The experience of new graduate nurses in rural practice in New South Wales. Rural Remote Health 2007; 7 814
| 1:STN:280:DC%2BD2snjsVOgsw%3D%3D&md5=883286aed2648b0779563ad7e030ebcaCAS |
 Gillespie J, Redivo R. Personal–professional boundary issues in the satisfaction of rural clinicians recruited from within the community: findings from an exploratory study. Aust J Rural Health 2012; 20 35–9.
| Personal–professional boundary issues in the satisfaction of rural clinicians recruited from within the community: findings from an exploratory study.CrossRef |
 Council of Australian Governments (COAG). Closing the gap in Indigenous disadvantage. 2012. Available at: https://www.coag.gov.au/closing_the_gap_in_indigenous_disadvantage [verified 13 July 2015].
 NSW Health. NSW Health Aboriginal Health Worker project: phase 1 report. Analysis of current NSW Aboriginal Health Worker environment. Sydney: NSW Ministry of Health; 2012.
 Watson C, Harrison N. New South Wales Aboriginal Mental Health Worker training program: implementation review. Darwin: Cooperative Research Centre for Aboriginal Health; 2009.
 Charmaz K. Constructing grounded theory. 2nd edn. London: Sage Publications; 2014.