Mental Health Minister Matt Doocey Photo: RNZ / Samuel Rillstone
Psychologists in Aotearoa are claiming a government proposal to create' associate psychologists' roles is dumbing down the profession and will harm patients.
The proposal from the Mental Health Minister is alarming clinical psychologists, who fear that with just one year of post-graduate training could ruin public trust and standards.
Minister Matt Doocey says the associates would only treat low-level patients, and be under supervision.
Over 200 psychologists have signed a joint letter addressed to Doocey, Minister of Health Simeon Brown and the New Zealand Psychologists Board.
The letter's author, clinical psychologist Laura Barkwill, told Midday Report anyone with an undergraduate degree in psychology could apply to do a one-year course and then would be able to register as an associate psychologist.
Currently, the pathway to psychology registration requires about seven years worth of training with a masters or PhD and a post-graduate diploma, Barkwill said.
"The content of the undergraduate psychology degree is not a mental health qualification, it's not designed to prepare people for individual work."
Most of the time it covers social psychology, some theory and nothing to do with mental health, assessment, therapy or working with people in distress, she said.
"Psychologist is a protected term for a reason. Just like you can't call yourself a doctor unless you have certain qualifications, you cannot call yourself a psychologist unless you have very specific qualifications and you are registered with the psychology board," Barkwill said.
"It looks like a way to say we're able to fill all of these positions within the public system, we're able to provide support to people, look at these registered psychologists we have when actually, we're completely dumbing down the profession and not making sure that people are registered with the appropriate skills to provide support for and intervention for those who most need it."
The public will not understand the difference between what a registered psychologist is providing and what an associate psychologist would provide, she said.
She was concerned the new roles would end up replacing those of the more qualified registered psychologists in the public system.
"So we could end up with a system full of associate psychologists with far fewer qualifications and far less experience, trying to deal with a population that are really distressed."
These are people who are highly suicidal, at risk of harm to others, huge mental health needs and difficulties.
"That requires a huge amount of training and supervision."
Mental Health Minister Matt Doocey. Photo: RNZ / Samuel Rillstone
Asked if the new role would take some pressure off long waitlists, Barkwill said one of the current issues is that training programmes take only a small number of people.
"My understanding is that Ministry of Health have increased some of the positions in the training pathways but they haven't then increased the amount of psychologist positions that are available within the public health service."
Barkwill said it was better to give these positions to psychologists.
University of Otago Associate Professor of Psychology Paul Skirrow had worked alongside assistant psychologists in the United Kingdom. He said they could be useful when used in the right way.
"Generally speaking, I've found these roles to be extraordinarily helpful when they are auxiliary to, so supporting the work of qualified clinical psychologists."
"I think one of the big concerns that everybody, including myself, has always had about this role is that it's not going to be used as an assistant or auxiliary role but it's going to be used to replace qualified psychologists."
The government and Te Whatu Ora needed to better communicate with psychologists about how the new role would work, to alleviate any concerns, Skirrow said.
"I think there needs to be a little bit more collaboration with the profession. It's been pretty rushed through, the whole thing.
"A lot of the psychologists in the profession probably don't feel they've really been brought along with this."
There were a range of views among psychologists and many of them did support the proposal, he said.
Mental Health Minister Matt Doocey said the new role is set up to be supervised by registered psychologists.
"The purpose of the associate psychologist role is for these graduates to work with lower intensity patients, under supervision, to free up and allow registered psychologists to focus on more complex cases."
Barkwill said when someone comes through the door you don't necessarily know what they will present with. She was not confident associates would have the support structures in place to recognise there was a problem or to know what to do next.
But Doocey said something needed to be done.
"We simply cannot sit around and do nothing, while New Zealanders are stuck on waiting lists without the support they need," he said.
"To suggest otherwise is disappointing. It is crucial to understand the associate psychology role is currently being developed by Health NZ in partnership with the tertiary sector and the New Zealand Psychologists Board. Health NZ are also working with the sector to develop the employer guidance and identify ongoing training and support for this workforce to ensure safe practice."
"We know, every single year there is a large amount of psychology students who are graduating with an undergraduate degree but are unable to progress further due to the limited number of post-graduate clinical pathways. This role keeps more people pursuing a career within the mental health and addiction workforce."
The role is one part of a programme of work to grow the psychology workforce, Doocey said.
He said the government is committed to double Health NZ funded clinical psychology intern numbers between 2023 and 2027.
