Two mental health social workers, one from New Zealand, the other from the UK, travelled to their respective antipodes to swap jobs for nine months.
Terry Mould and Maggie McKeown explain how it is going so far
At the end of 2008, Terry Mould, a social worker from a community mental health team in Romsey, Hampshire, job-swapped with Maggie McKeown, a social worker from a CMHT team in Ashburton, New Zealand. Five months in they talk about the experience.
In September 2008, I heard from Neil Dhruev, my director of mental health at Hampshire Partnership NHS Trust, that I could exchange with a social worker in New Zealand.
I am five months into a nine-month exchange working for the Canterbury District Health Board (CDHB) at a community mental health team in Ashburton (locally known as Ash Vegas), south of Christchurch on the South Island coast.
My reasons for doing the swap go back a long way. I had worked in Christchurch for six months six years ago. The contacts developed meant a return was possible – that and an understanding wife and family.
My e-mails to the CDHB social work adviser, Brenda Cromie, brought a swift response. One of her team members, Maggie McKeown, loved the UK and I loved the qualities that New Zealand represented: sun, the outdoors, few cars and less stress.
I have learned a lot from the relaxed pace of life. It does feel a bit like being transported back in time: they do catch up with some of the UK TV shows and Life on Mars is ironically one of them. However, six years ago the CDHB computerised health links client/patient staff recording system was streets ahead of our own – and still is.
NZ medical model
The medical model still prevails in New Zealand. Resources are scarcer, with less opportunity for psychological-based therapies. But New Zealand – and the CDHB in particular – has a more comprehensive range of government support services equivalent to our own community care support. Their dedicated needs assessors arrange services, such as respite care, which is more available in New Zealand.
Ashburton CMHT covers a huge area there are three CMHTs in my home district of the New Forest, which also has separate, dedicated crisis, assertive outreach and early intervention teams. Romsey has a new state-of-the-art hospital nearby, Ashburton’s psychiatric unit is more than 35 miles away and was built before the last war.
There are similarities between the two countries. On mental health issues, such as the reduction of suicide rates (a major driver on policies and procedures), there has been a shift in practice towards assessing risk. However, this has sometimes been to the detriment of the quality of service provision.
As in the UK, media reporting gives a blinkered view. Reports of methamphetamine drug-fuelled child abuse and homicides are rife here, equivalent to the UK’s child care tragedies and gang violence.
Nevertheless, New Zealanders appear to have more respect and consideration for others. This can be frustratingly boring when it comes to changing things. Working conditions and employment rights have moved on little in the past six years. However, living here makes you realise that there is more to life than having the latest household device and luxury item.
It is a joy to take part in activities without having to pay the earth. I have seen more films at cinemas in five months than in the past 10 years at home, partly because TV is so awful, but mainly because everything is more accessible and within people’s budgets.
A change is as good as a rest, they say, and how fortunate I have been in undertaking a sabbatical like this. I believe it will enhance self- and organisational development. The exchange of ideas and work practices through working in other countries has enormous benefits.
Opening my e-mail in May 2008 I was surprised to read about a social worker in the south of England who wondered whether anyone was interested in a job swap.
It was an attractive proposition for several reasons. It would be like returning to my second home: I have a British passport because my father emigrated to New Zealand in the 1920s and I had worked throughout the 1990s for Hampshire Council and then Southampton Council. It meant I could renew old friendships and see family again.
The support and enthusiasm from my manager, senior management and colleagues allowed this exchange to take place. They saw it as a chance to look at similarities and differences between the two countries and bring back ideas from the UK.
I work in a small, rural community mental health team in Ashburton, New Zealand, which serves about 27,000 people in a farming town and surrounding district from the mountains to the sea and between two major rivers.
My role at Romsey CMHT is as a qualified social worker/care manager. My caseload is 22 clients, mainly moderate to long term. I am interested in the number of groups that are being managed to meet the needs of a variety of clients from emotional coping skills, anxiety, personal development, dialectical behaviour therapy (for those with borderline personality disorder) and cognitive behavioural therapy.
Attendances are high at the groups, there are positive changes in behaviour and feedback is positive, especially from clients with a diagnosis of borderline personality disorder and the clinicians working with them.
When a routine referral is made to the CMHT in Romsey they are booked into assessment clinics held on two half-days, twice a week. Urgent referrals are seen by the duty officer on the same day. This is different from Ashburton where assessments are carried out daily, depending on urgency, by the consultant psychiatrist, registrar or clinicians.
A factor in this is that the role of the CMHT in Ashburton includes crisis work. In Romsey the crisis resolution home treatment team plays a valuable role in supporting the CMHT by working daily with the client for up to six weeks.
I was surprised to learn an ambulance is most often in attendance when an assessment under the Mental Health Act 1983 is required. If the detained patient has been given a psychotropic medication or sedation of any type an ambulance is often required in the convoy. In Ashburton we are an hour from the nearest psychiatric hospital and the patient is taken in a departmental vehicle perhaps with a police escort or in a police car.
This experience will have long-lasting memories for me, particularly for the things I have learned and the ideas I can return to New Zealand with.
However, I will not miss the endless traffic, difficulties in parking, and filling in travel claims after every business journey because staff use their own cars to carry out their work. In New Zealand pool cars are used for any departmental business. I will miss the English countryside, those delightful villages and the shopping.
Saying goodbye is always difficult as I regard both New Zealand and England as my homes. I am equally comfortable living and working in either country and feel fortunate to have experienced this wonderful opportunity.