We can’t solve the mental health emergency in Australia if we don’t train enough psychologists. Here are 5 fixes
Almost 50% of Australians suffer from mental illness during their lifetime, costing our economy up to A$220 billion a year, according to pre-pandemic figures.
The full impact of the pandemic on our nation’s mental health is still emerging, but the early signs are grim, with one in five Australians suffering from a mental health disorder between 2020 and 2021.
This includes 3.3 million people with anxiety disorders, 1.5 million with mood disorders, 650,000 with substance use disorders and over 3,000 suicide deaths each year.
But accessing help can be very difficult. Government investment in psychology training programs is part of this problem.
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A serious shortage of psychologists
Currently, the federal government is only meeting 35% of its psychology workforce target.
One in three psychologists say they have closed their books to new patients, due to overwhelming demand. Despite this, psychology workforce issues were not on the agenda at the recent jobs and skills summit.
Brain and mental health disorders, including stroke, dementia, ADHD, depression, and alcohol and substance abuse, are major causes of disability, with significant personal and societal impacts.
Timely diagnosis, evaluation and treatment for these complex conditions are crucial. However, these services require psychologists with advanced training. This includes clinical psychologists, clinical neuropsychologists, counseling psychologists, educational and developmental psychologists, forensic psychologists and health psychologists. These psychologists are fully trained in the assessment, intervention and treatment of people with mental illnesses and brain disorders.
Hundreds of positions for hospital psychologists remain vacant, with patients (including children) waiting up to two years to receive care. Positions are often advertised for months without qualified candidates, especially in regional and remote hospitals.
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Psychology training places are dwindling despite high demand
Postgraduate psychology courses are expensive to run, requiring high staff-to-student ratios and incurring high clinical supervision and placement costs.
Unlike medical degrees, government funding for these programs does not cover course costs. Recently cut support from the federal government is half that given to veterinary science. This means universities are losing money on these programs, making them an unattractive financial prospect for ever-tighter higher education budgets.
This has led to program closures, despite a consistently high demand for training places. Across Australia, the number of clinical neuropsychology training programs has fallen from eight to five over the past ten years. There have been similar cuts in health, counseling and forensic psychology training.
La Trobe University’s Neuropsychology program received more than 300 applications per year for up to ten places, but the program was closed in 2020. Similarly, according to course organizers, clinical psychology programs regularly receive at least 20 candidates for each available place.
Universities are now resorting to cutting government-funded master’s places in favor of expensive full-fee places (around $35,000 per year), impacting affordability, equity of access and the diversity of students. This disrupts any attempt to develop a culturally and socio-economically representative workforce and does not meet the needs of our health sector.
Many psychologists choose to enter higher-paying private practices straight out of college, bypassing public health roles. This affects the general public’s access to mental health services.
We must do better. Vulnerable people living with mental health issues deserve support and protection.
5 Solutions to the Psychology Workforce Problem
There are simple steps that could go a long way in fixing this problem.
Increase funding for postgraduate training in psychology so that universities do not lose money by offering these programs.
Ensure that a minimum number of Commonwealth-supported places (i.e. tuition-free or reduced tuition) are protected for students in psychology training programs and ensure you that they correspond to labor demands and vacancies.
Consider training models that incorporate “return of service” obligations. This is when the government subsidizes tuition but requires graduates to engage in paid health services for a minimum period, such as two years.
Invest in joint psychological staff positions between the university and the health services (as is the case in medical training) to provide supervision and internships in the sector.
Increase placement opportunities for postgraduate students through better collaboration between universities, services and government.
All Australians deserve to have their mental health needs taken care of by trained and qualified psychologists. Investing in the psychology workforce will be good for the economy, increase total workforce participation, reduce wait times and save lives.
The authors would like to thank Tamara Cavenett (President, Australian Psychological Society) and Lynda Katona (Head, Psychological Services, Alfred Health) for their contributions to this article.