Together we’re stronger
I believe in unity, compassion and understanding. I strive to be inclusive, open-minded, incisive and useful.
While I adore them, my life hasn’t been all rainbows and unicorns. I’ve had my head down for some decades now, working hard to be who I am, do what I do, and do it as best as I can.
As an early career psychologist, I’m relatively new to the profession and have balanced family and work with extended study and training for some years. I believed that the APS would always be a voice for me, would represent all registered psychologists, would support all psychologists in the face of government cuts, wouldn’t undermine my skillset or work capacity.
But unfortunately, and especially in light of the recent Medicare Item Review submission, it seems I had it wrong.
Instead of unity, I see “us and them” mentalities abounding (both sides), personal and generalised slurs (both sides), frustrated psychologists asking for answers, hopeless psychologists abandoning ship, and a bigger picture hinted at, but not plain to see.
I truly believe that it doesn’t serve us to be split along training-pathway-lines. We’re got a better chance of tilting the rudder of the larger societal ship if we speak with one voice.
And Australia needs us.
Uncertainty is rife. Our youth are experiencing serious mental health issues, our older adults dementia, and all suicide rates are rising at an alarming rate. Our educators are not coping with mental health demands and learning needs of students, our organisations are trying to cope with workplace bullying and productivity issues, the prison system is a mess with poor funding for evidence-based rehabilitation programs and training/help for staff.
We are the voice of the vulnerable and disenfranchised clients we see and organisations we help.
A strong united Australian Psychological Society is an essential platform for pressing agendas. It’s already known and has a seat at the table. We need to speak clearly for psychology and for Australia’s future.
Better Access was intended to provide better access to mental health care for everyone. We’re all competent, qualified psychologists. We’re practicing in the same system with the same expected and accredited standards determined by APAC. But the public is currently being done a disservice. The Better Access service delivery model is skewed towards favouring services delivered by only one type of psychologist. This has kept government spending manageable but has had other, possibly unintended, consequences.
1. Clients are being inequitably reimbursed by the two-tier Medicare system for psychological services.
Inequities in rebates and our human Western tendency to value services by price differences have contributed to the current implication that one arena of psychological practice is always better than another. Variations in government rebates and policies suggest clear-cut differences in psychologists’ outcomes without supporting evidence. I’m not saying we’re all the same – we’re not, no group of professionals is entirely homogeous but we’re more similar than different when we’re providing similar services to similar clientele.
This inequity disproportionately affects rural Australians who we know already experience difficulties accessing services.
2. While a focus on mental illness is a national priority, it is not the only aspect of mental health, or indeed the only aspect in psychology.
Learning difficulties are not mental illnesses yet left untreated can lead to negative life outcomes. Dementia in ageing isn’t classified as a mental illness but imposes an unfair and significant emotional, physical, mental and financial burden on individuals and our healthcare system. Being bullied at work isn’t a mental illness but it can take a massive toll on both employees and employers. We need to ensure that the breadth and diversity of our practice is protected and supported into the future so that gropus like these can be looked after well.
Diversity in our training courses has plummeted. Last year there were 90 programs delivering a clinical speciality and only 68 programs serving all the other areas of practice endorsement. Under the new APAC standards, the first 5 years at University will be the same for everyone. These standards state that to be registered for practice, a psychologist must be capable of a wide range of evidence-based skills including psychological assessment, diagnosis, intervention and continuing mental healthcare of clients.
However the shrinking of programs means there is an unacceptable risk that our broad field of practice will be slowly reduced to only clinical psychologists providing clinical services for mental illness.
3. The public is disadvantaged because of increased restrictions on practitioners, such as diagnostic reports for Centrelink only accepted from clinical psychologists.
Negative effects from policies such as this include excessive wait times, changing psychologist mid-treatment, and duplication of services. Likewise, the current confusion regarding the NDIA’s advice around diagnostic capabilities of psychologists is affecting the public adversely, reducing availability to a small population of clinicians.
My goal is to address inequity and ensure that the opinions and needs of the many are heard as we move into the future of mental healthcare. The public deserve to be provided with fair evidence-based subsidies and policies for assessment, diagnosis and care by all registered psychologists.
It’s time that the disunities and inequalities confronting our profession now are resolved, frankly and transparently. I’m not sure of the best way to do that, but I’m certain it’s not happening now.
Communication 101 tells us to seek first to understand, and then to be understood. I want to understand what’s gone on and help figure out a way we can move forward together, with shared respect and a common purpose.
The future is not set in stone but one thing is sure.
Unless we act to change things, we’ll end up with a too-tightly-focused, polarised workforce, unable to meet the diversity of psychological issues facing Australia.