Today, AAPi Director Carly Dober's commentary on the reasons for and solutions to the shortage of psychologists was featured in The Australian.
This commentary references the article Turning away eager students in a psych crisis “insane” (The Oz, 1 September 2022) which points to the lack of Master's degree positions as being to blame for the workforce shortage. While more can and should be done regarding the educational offerings to the next generation of psychologists, we believe this article does not accurately reflect the underlying issues which include but are not limited to the retirement of the 4+2 pathway (AAPi was the only psychology association to oppose the closure of this option) and the two-tier system which has decimated the diversity of educational offerings for future psychologists. Carly discusses this in her opinion piece below.
Crucial steps could help ease the shortage of psychologists
The chronic shortage of psychologists to meet the Australian population's demands for mental health support requires urgent intervention from policymakers and all levels of government. This shortage is due to a number of important factors, culminating in the crisis we are experiencing today.
Firstly, there is the retirement of the 4+2 year internship program pathway that psychology students could once pursue, to access full registration and work in mental health as a registered psychologist. This 4+2 pathway consisted of an undergraduate degree, an honours year and two years of supervised practice as a provisional psychologist, with students gaining valuable real-world experience under the guidance of an experienced psychologist. This has long been the primary pathway to becoming a psychologist rather than the higher degree pathway, which can be limiting for people who cannot afford to study full-time for six-plus years.
Secondly, the devaluing of the generally registered psychologist cohort as a result of the Medicare two-tiered funding system. Currently, the Medicare rebate for clients of clinical psychologists is significantly higher than the rebate for clients of general psychologists or those with endorsement in the eight other areas of psychology. Both groups have a minimum of six years of education and training. Both groups can assess, treat, and support their clients. This two-tier system directly impacts the number of psychologists who can provide a bulk-billing service to Australians. It creates unnecessary financial and access issues for so many Australians, which is why AAPi has long been advocating for the Medicare rebate for all clients of all psychologists to be raised to $150.
There is also a rich diversity of psychologists who currently work in Australia.
According to the Australian Health Practitioner Regulation Agency, as of June 2022, there were 44,917 psychologists in Australia. Over the past 15 years, there has been an increase in representative and funding bodies distinguishing between psychologists with a ‘clinical’ endorsement and other psychologists. This has resulted in a now commonly held misconception that psychologists with clinical endorsement (who make up only 25% of all psychologists) hold greater qualifications, expertise, and competency than the remaining 75% of their colleagues.
To date, there is no evidence of a difference in outcomes for clients of clinical psychologists compared with registered psychologists. The AAPi sees the two-tier system as fundamentally divisive and unnecessary, with a detrimental impact on Australians requiring urgent access to psychological care.
Thirdly, AAPi has long been advocating for the Medicare rebate to include the 7,942 provisional psychologists to be able to provide mental health support to Australians. Provisional psychologists have undertaken a minimum of four years of education and could very quickly alleviate the strain on the mental health care system. They are required to be connected to a senior psychologist to supervise their work, and the mobilisation of this workforce would certainly be a welcome inclusion for many private practices, schools, general practitioner clinics, community mental health services, and the like.
AAPi believes these well-evidenced solutions could revolutionise the mental health system in Australia, and most importantly - the mental health and wellbeing of Australians. It is our strong hope that the government listens closely to organisations that are dealing with this mental health crisis first-hand and takes some bold steps towards transformational reform.