Invisible value

The quiet inequity undermining our sector

I’ve worked in mental health and addiction services for decades. But it wasn’t until I crossed from the DHB system into the NGO sector that I fully appreciated the breadth and depth of clinical expertise we have working in our community-based services.

It’s easy to focus on the visible parts of our workforce — our peer support specialists, youth workers, support workers. Their work is essential, and rightly celebrated. But what I see, and what we risk missing, is the growing number of clinicians operating within NGO settings — mental health nurses, occupational therapists, psychologists, social workers, addictions specialists — quietly delivering high-level, evidence-based care across complex and varied services.

Let's stop hiding our clinicians in plain sight.

There’s been a long-held assumption — often unspoken, but still pervasive — that if you’re a clinician working in an NGO, you’re somehow “less than” your counterparts in specialist mental health or primary care. That assumption is wrong. It undermines the value of the work, and it holds the sector back.

True value

The reality is our clinicians bring a skillset that is just as robust, just as accountable to evidence, and often more holistic in its application.

We’ve moved beyond the old idea of a one-size-fits-all “registered health professional.” That term flattens a workforce that is rich in specialist knowledge.

Naming the profession matters — because recognising a nurse or an OT or an addictions clinician for their specific training and contribution is the first step to properly supporting them.

What do clinicians in the NGO sector bring?

Five things stand out.

They’re trained in the therapeutic use of self — the ability to build trust and form relationships that are the cornerstone of all mental health care.
They’re deeply skilled in talking therapies: CBT, DBT, motivational interviewing — techniques grounded in evidence and adapted to the realities of the people we support.
Advanced risk assessment capabilities, helping teams make informed, balanced decisions about safety and wellbeing.
Addictions clinicians in particular carry specialist knowledge of harm minimisation, withdrawal support, and substance use.
Understanding of trauma. They work across diverse services and with diverse tāngata whi ora and whānau where trauma is present every day and they actively work to avoid triggering trauma response and re-traumatisation.

In other words, they are experts. But we don’t always treat them that way.

Pay equity

One of the biggest barriers we face is pay. A clinician doing the same job, with the same training and responsibilities, gets paid more in Health NZ/Te whatu ora ,or in primary care than they do in the NGO sector. That has to change. We cannot expect to grow and retain a skilled workforce while asking them to accept less because of where they work.

Active support for professional development

This isn’t just about fairness — it’s about sustainability. If we want to keep clinical talent in the sector, we need to create career pathways, not just roles. We need to give people a reason to stay. That means actively supporting professional development, investing in postgraduate training, and making full use of initiatives like the New Entry to Specialist Practice programme. We need to be strategic and intentional — not just about who we bring in, but how we grow the people we already have.

The power component

Clinicians in NGOs often straddle two worlds: the clinical language of specialist services, and the recovery-focused language of the NGO sector. They understand what support workers do, because they work alongside them every day. They know that effective care isn’t hierarchical — it’s relational. That insight is powerful. It’s what makes our model of care distinct.

Stop glossing over our clinical workforce. Name it. Value it. Fund it.

Because the future of Mental Health and addiction care won't just be within our specialist serives it will be built – quetly, steadily – by the people doing the work where its matters most, in our communities.

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