Profile: Nicola Livingston

Getting the message across
Advocacy and support

Young Nicola Livingston was strongly influenced during her childhood by the volunteer work her mother did with people needing help in their small rural community.

As a member of the Women’s Division of Federated Farmers (now called Rural Women) Nicola’s mother was always helping people out, particularly the elderly.

“My mother was essentially a community worker and my earliest role model, because I would often go with her when she visited people. What really impressed me was that she supported people. She didn’t take over and tell people what they should do. She would ask people what they needed and wanted; often it was just about listening.”

As she grew older Nicola decided she wanted a career where she, too, could work alongside families and individuals who needed support in that manner. At 16 when she came across social work, she knew she’d found that career. Sixteen years later, she is more involved in social work than ever. 

Mental health became her focus when she landed her first job as a support worker in a mental health day programme in Hastings, after graduating with a social work degree. The role involved supporting clients to learn practical and emotional skills, gain confidence about making their own decisions and advocate for themselves.

“I had never thought about working in mental health but I really enjoyed it. The client group was great; they were interesting, had lots of skills and potential. They taught me heaps, and had great stories which they willingly shared.”

After a year Nicola moved to a mental health role in an elderly specialist team, working with people (and their families) with dementia and cognitive impairments. Both jobs cemented her interest in mental health.

She then spent two years overseas doing medical social work, before returning to New Zealand where she worked in a variety of jobs, including a medium secure forensic mental health unit, before another stint in medical social work. In 2002 she moved to Midlands regional forensic Mental Health service at Waikato District Health Board (DHB) where she is now clinical leader of the Social Work, Mental Health & Addictions Service. The leadership role is evenly divided between clinical project work and clinical leadership, she explains.

“At a practical level my role includes recruitment, performance appraisals, orientation of new social workers, supervision and supporting of social workers to develop their practice. It also involves workforce development and looking at ways to develop the social work service to meet the needs of service users/ tangata whaiora. It’s also about making sure social work is actively involved in any service development occurring within the mental health and addictions service.”

It is a rewarding role, says Nicola, who has been involved in developments such as a joint venture between Health Waikato and Connect Supporting Recovery to provide residential rehabilitation services to a client group with a high level of need and a new child and youth after hours mental health service for the Emergency Department.

“I’m lucky because I’m supported by a high level of skill and expertise in social work service across the mental health and addictions service.”

Over the past year Nicola has seen the numbers of social workers grow and move into new practices in mental health. There are now 42 social workers in mental health in the service, based in Hamilton, Thames, Tokoroa and Te Awamutu. They work in areas such as maternal mental health, infant, child and adolescent mental health, alcohol and other drug services, rural adult mental health community teams and mental health for older people.

The least enjoyable part of the clinical leader role is having to accept you can’t influence change straight away, says Nicola.

“Working in a large organisation with many systems often means change can be a slow process. I also don’t enjoy misconceptions held by some people about the role of social work in mental health, although this can be an opportunity to educate and promote social work!”

Indeed, part of her job is to educate colleagues from other professions about what social work offers mental health. Social workers look at the person as a whole and work alongside them within the communities and the systems they exist in, particularly family and whanau, explains Nicola.

“This is facilitated by the use of psycho-social assessment and intervention which underpins the social work approach, such as genograms (like a family tree) or ecomaps.”

These are methods that social workers use with service users / tangata whaiora if they are finding it hard to talk about themselves and their related social, family, whanau and emotional and health related issues.

By using drawings to explain their relationships and where they fit, service users often start to express themselves and communicate more effectively.

“Social work is all about communicating effectively with those we work with and being flexible about how we do that.”

The strengths based and client centred approach of social work fits in well with recovery approaches, she adds, as does the emphasis on advocacy at an individual and group level.

“As agents of change can we can identify gaps or areas where service users/ tangata whaiora experience marginalisation and challenge the systems and processes that marginalise, including stigma and discrimination.”

For example, says Nicola, social workers advocate on an individual level every day to ensure that service users receive their fair entitlement of services from agencies and organisations.

Working with service users/ tangata whaiora to identify supports and networks and work toward reconnecting people to those networks is another important part of social work within mental health. Therefore social workers need strong networking skills and knowledge of resources and organisations in the community that service users/ tangata whaiora can link into, says Nicola. An important part of her role as clinical leader, is to encourage the social workers working in mental health and addictions service at Waikato District Health Board to remain updated about community resources and maintain links to communities, resources and colleagues.

Page last updated: 16 November 2009