18 May 2024

New 'assistant psychology' role in development by government to address workforce shortages

7:26 am on 18 May 2024
Stylised illustration of two people in chairs during a therapy session

Only 50 clinical internships for psychology are offered each year, leaving a large shortfall against demand for their services. Photo: RNZ

A new qualification allowing psychology graduates to treat patients is being explored by Mental Health Minister Matt Doocey.

It is hoped the new 'assistant psychologist' role will help fill the large number of clinical psychology vacancies and reduce waiting times for patients seeking help.

More than 350 clinical psychologists need to be trained each year to meet the vacancy rates of Health New Zealand, but there are only 50 clinical internship placements offered each year, leading to a huge shortfall and long waiting lists in both the public and private sector.

In a bid to expand the workforce, Doocey wants to create a new 'assistant psychologist' role, which could offer help to people under the supervision of a clinical psychologist.

"There's a couple of hundred people who graduate every year in undergraduate psychology, who when they don't get one of those 50 clinical internship placements, they basically disappear," Doocey says.

Officials are working on what a new registration would look like.

"It's fair to say I'm getting quite a positive response from officials who think it could be quite a significant change, and a registration that will support more professionals in psychology and hopefully less vacancy rates," he says.

Assistant psychologists, or 'psychology associates' as they are sometimes called, provide 'low-intensity' cognitive behavior therapy or carry out psychometric testing, freeing up time for clinical psychologists to deal with more complex cases.

The idea is not new. In 2019, the Psychology Workforce Task Group, convened by the Ministry of Health, proposed a new workforce role of 'psychological wellbeing practitioner' or PWP, based on a model introduced in the United Kingdom in 2008. It has not progressed in New Zealand.

An evaluation of the UK programme's first three years, which aimed to increase access to evidence-based psychological therapies, found two-thirds completing treatment showed clinically meaningful improvements and 41 percent attained complete recovery. More than 45,000 participants had moved off sick pay or benefits as a result.

Assistant psychologists are also common in the United States and Canada.

While a new role could be some years away, Doocey says he's keen to get the ball rolling.

"I'm meeting Tertiary Education Minister Penny Simmonds very soon about this proposal as well, and we'll be looking to see how long it might take the universities to get this new registration up and running."

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Mental Health Minister Matt Doocey Photo: RNZ / Samuel Rillstone

Ministerial briefing documents show the 2019 proposal from the Psychology Workforce Task Group to establish PWPs was consulted on, but gathered "contrary views".

"Particularly from Māori health leaders who had significant concerns that the English model did not include a mātauranga Māori approach. Concerns were also raised that consultation primarily focus on the views of clinical psychologists, rather than the broader psychology profession," the February paper says.

College of Clinical Psychologists spokesperson Paul Skirrow welcomes the move but says there's a lot of detail to work through as a new qualification would require universities to commit to training people.

"Particularly given the fact that they've got real funding constraints at the minute," says Skirrow, who is also Director of Neuropsychology Training at Otago University.

"It requires the Minister of Education to give enough funding for these courses; it requires a university - if not several - to be sufficiently interested to put in the effort to set up a program; and in the current financial situation you've got to convince the universities that this is going to be profitable, or at least breakeven.

"So even if ministers are really keen on this, it's not a simple thing.

"We've seen from overseas that these can be enormously helpful in meeting the huge demand for mental health services, the main thing that we wouldn't want to see is a loss of quality. So we really need to make sure that we get the details right, and that people are properly trained and properly supported by clinical psychologists.

"But overall, we really think this could be a real positive towards improving mental health."

Co-director of Auckland University's clinical psychology programme Tania Cargo says the money would be better off spent on increasing the number of clinical psychologists being trained.

"It comes down to where do you put your buck? PWPs are a great idea but New Zealand doesn't have enough clinical psychologists to oversee them, so we need to grow the clinical psychology workforce first."

She hopes the government will consult with universities and the psychology profession about its plans.

"We want to be part of the solution and discussion," Cargo says.

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