Buried deep within the budget papers was an ominous reference to a new type of mental health professional. Undertrained, unregulated and ‘concerning’, says ACPA.
Clinical psychologists are afraid the government has plans to create a role within the healthcare system akin to that of the UK’s physician associates, following the inclusion of a mysterious one-line budget item.
The sentence itself is buried at the bottom of page 20 in the 2024 Budget Health Stakeholder Pack, in a paragraph about expanding the lived experience peer support workforce.
“This Budget will diversify the psychology workforce, and explore the role that psychology assistants might play in the mental health workforce,” it read.
The Department of Health and Aged Care confirmed with The Medical Republic that the role would be based on the NHS “assistant psychologist” model, as suspected by the Australian Clinical Psychology Association (ACPA).
DoHAC said the move was part of a broader effort to “to support more psychology graduates to use their skills”.
The NHS role is a relatively structured pathway for people with an accredited psychology undergraduate degree who are working toward getting accepted into a post-graduate or doctoral program.
Their duties include doing assessments and behavioural observations, investigating histories, carrying out treatment programs and working in multidisciplinary teams.
Assistant psychologists must be supervised by a registered practitioner psychologist, who retains overall clinical responsibility.
ACPA president Professor Caroline Hunt told TMR she was concerned that the government was looking at allowing Australians with undergraduate degrees in psychology to step into health system roles.
“In psychology training, the first three years of the honours [undergrad] degree is very much focused on the science of the discipline of psychology, and the honours year is very much focused on research with a little bit of applied stuff,” she said.
“[Undergrad] is really trying to cater for people who might want to leave the degree to go into HR or marketing.
“The core mental health training would be happening in a master’s degree.”
She believes that the “assistant” role referred to in the budget papers would be distinct from a provisional clinical psychologist, someone who has completed an undergraduate degree and has been accepted into a psychology masters program.
“At the moment, there’s nothing like a psychology assistant,” Professor Hunt said.
“The idea that you have somebody with no mental health training come into the workforce without any real plan of what they would do and who would supervise them and where they would be based [is concerning].”
The prospect of psychology assistants is particularly relevant to general practice right now, given the unfolding crisis relating to physician associates in the UK.
Physician associates qualify with a bioscience-related undergraduate degree and complete a two-year Master of Physician Associate Studies program which involves around 1600 hours of clinical training.
They aren’t allowed to prescribe or order ionising radiation, but recent evidence suggests that some trusts are bending the rules.
Major NHS-style changes to the Australian health workforce are not an impossibility.
The first paper out of the wide-ranging Scope of Practice Review heavily implied that the government was looking to the UK as an example of how to move forward.
ACPA’s concerns mirror those of the many other health specialties concerned about scope of practice.
“They’re not really psychologists, so there’d be no regulatory oversight of these people,” Professor Hunt said.
“There are people who do have already have regulatory oversight – they are psychologists and endorsed psychologists and there’s already a pipeline for them.
“Frankly, we need the workplaces for placements and we need the supervisors to train … the people on the recognised pathway to accreditation.”
The Royal Australian and New Zealand College of Psychiatrists has adopted more of a wait-and-see approach.
“Psychiatrists deeply value our colleagues across the mental health sector and often work in multidisciplinary teams,” college president Dr Elizabeth Moore said.
“Right across the sector we face challenges with chronic workforce shortages and issues with scope of practice.
“It will be important for the development of any role for psychology assistants to be informed by the insights and needs of psychologists and their professional bodies.”
