The Australian Psychological Society (APS) supports a review of the structure of mental health funding in response to the mental health crisis in Australia, but warns a general practice-focused approach is woefully inadequate without urgent funding to ensure qualified psychologists are available to provide high quality treatment.
APS President Tamara Cavenett described assertions from the Royal Australian College of General Practitioners (RACGP) that GPs should receive incentive payments and funding for longer telehealth consults as short term and unsustainable solutions.
"This proposal could place Australians in need of mental health care at risk, and see burnout and mental health issues in our already stretched GP workforce increase.
"GPs are highly valued members of the health workforce, working at the front line of primary care, but they do not have the skills, expertise, or many years of highly specialised, mental health-focused training to perform the work of psychologists.
"We've been telling government for years that there is a looming shortage of trained psychologists and that this is the problem that needs to be addressed – asking overstretched GPs to spend more time in a high-risk area like mental health is not the solution our health system needs.
"We could double the supply of graduating psychologists overnight with supported training, which is the long-term solution vulnerable Australians deserve and need.
"The crisis in mental health in our regions requires urgent attention including funded placements, regional incentives and scholarships to address workforce issues – not just longer consults with GPs, many of whom also already have their books closed or extensive wait times even for urgent medical appointments.
Psychologist workforce is trusted, but unpaid, underfunded and overworked
Ms Cavenett said the APS has put many practical solutions forward to government to address the nation's mental health crisis.
"APS data shows that 1 in 3 psychologists have closed their books to new patients. The solution to this problem is not to shift patients across to GPs – it is to better invest in the psychological workforce, get more psychologists where we need them, and get patients in front of a psychologist sooner.
"The Federal Government is only meeting 35% of its psychology workforce target listed in the National Mental Health Service Planning Framework. That is the largest shortfall of all mental health professions.
"Lived Experience Australia last year found that over 90% of patients and carers would recommend a psychologist, yet our critically low workforce continues to face enormous and growing pressure.
"Further research shows psychologists continue to answer the call during the pandemic, working on average 17 unpaid hours each week and being paid for just 23 hours. Psychologists working with children recorded an additional 2.2 unpaid hours worked, on average.
"By comparison, GPs work an average of just 5 unpaid hours each week.
"We've had enough. We urgently need more support to bolster this highly trained, expert workforce.
GP referrals creating a bottleneck, especially in rural areas
Ms Cavenett said current Medicare referral requirements were in fact contributing to Australians' issues accessing the care they need, especially in rural, regional and remote Australia.
"The red tape around GP referrals is an absolute nightmare for patients in their time of need.
"Removing the GP referral process from the mental health care plan, so patients can see a psychologist for up to 3 sessions without referral from a GP, will get patients to psychologists sooner and ease the pressure GPs are saying they are under.
"The provision of mental health services by videoconference has been a silver lining of the pandemic. With such care now accessible, affordable and effective, location should no longer be a barrier to expert mental health care.
"This should remain a permanent fixture, and innovative solutions using technology to link patients to available psychologists should be explored and funded by government, to ease strain on GPs and increase access to trained psychologists.
"We also want to see the government replicate the regional relocation incentives given to GPs for psychologists.
"This will help us attract more psychologists to rural, regional and remote Australia where we know patients are quite literally crying out for help.
"We can turn this crisis around with urgent action and strong leadership.
"These are sustainable solutions that get the workforce where we need it, fast.
"By investing just $5 million, we can create more than 3,500 supervisors and 6,000 additional placement psychologists within 2 years."
The APS is calling on the Federal Government to:
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Get patients to psychologists sooner by removing GP referral requirements
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Expand Medicare coverage and lower the gap fee for patients
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Make the additional 10 per annum Medicare-funded psychology sessions a permanent feature of the Better Access program
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Replicate GP regional relocation incentives for psychologists, to attract more psychologists to regional, rural and remote Australia
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Provide psychology graduates with incentives to work in rural and remote locations equivalent to those being offered to doctors and nurses, i.e., by eliminating their HECS debt, providing scholarships and other Medicare-related benefits
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Invest just $5 million to create more than 3,500 supervisors and 6,000 additional placement psychologists within 2 years
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Promote workforce opportunities in rural and remote locations, and with our most vulnerable groups, by funding the APS to arrange intensive student placements in these areas
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Increase psychological services for perinatal mental health in rural, regional and remote areas via innovative service models (including digital health services, telehealth and incentives for psychologists)
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Put psychologists in schools with a ratio of 1:500 for public, private and independent students
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Fund universities to reinstate and/or develop appropriate Master's programs (both MPP and, in particular, for AoPE) to ensure adequate diversity and expertise within the psychology workforce.
