New Zealand was already estimated to be 940 psychologists short before this week’s call in the Inquiry report for more Kiwis to have access to talk therapies, according to a Taskforce.
Dr Malcolm Stewart, president of the College of Clinical Psychologists, applauded the Inquiry report’s recommendation to increase access to psychological (talking) therapies –and its call to increase the psychologist workforce – because the shortage meant many people in need are currently missing out.
The Mental Health and Addiction Inquiry report released on Tuesday said substantial new and extra investment was needed in the mental health workforce to meet its recommendation of a major expansion in the number of people reached by mental health and addiction services – from the current 3.7% per cent to more like 20% within five years – particularly increasing access to evidence-based talk therapies.
The report said while other skilled, trained professionals can offer talk therapies there was an immediate need to invest in training more psychologists because of the long lead-in training time (about six years in total). Also that Health Workforce New Zealand modelling suggested that numbers were already not growing fast enough to keep up with population growth, even before the Inquiry report calling for a significant expansion in services to cover more people with mild to moderate needs.
Stewart said despite the importance of skilled psychological therapies that access – even through DHB mental health services – was currently limited meaning “many people who could gain major benefits cannot get therapy”. Also while many people choose to go to a psychologist in private practice the cost stopped this from being an option for everyone.
He said work undertaken by the Psychology Workforce Taskforce Group (PWTG) – set up by the Ministry of Health and Health Workforce New Zealand – estimated that an additional 268 psychologists were needed across the 20 DHBs and about 672 more in the primary health/general practice sector to adequately address the need for psychological services.
This extra 940 psychologists would allow about 5 per cent of Kiwis – with a range of mild to severe needs – to receive appropriate levels of psychological assistance through the health system in any one year.
Stewart said only about 130 trainees enter professional postgraduate psychology training programmes each year. “So there is a large discrepancy between the number being trained and the numbers required.” Also graduates are not just in demand in the health sector but also in a range of social service agencies with Corrections and Oranga Tamariki both signalling they intended to increase their psychologist workforce, said Stewart.
“Work is underway to boost the number of psychologists being trained to help to meet this increased need,” said Stewart. But he added that other strategies – such as recruiting from overseas and improving retention of psychologists in the health services – were also important.
In 2017 the New Zealand Psychologists Board registered 239 new practitioners – 100 of them were trained overseas and 139 trained in New Zealand. Currently there is a total of 2793 registered psychologists practising in New Zealand in a variety of scopes of practice including clinical psychologists (1600) and educational psychologists (222).
Other talking therapy providers also needed
Stewart said provision of psychological therapies, by people other than psychologists, was also important. “Many psychologists are keen to support this to ensure that people in New Zealand have access to safe and effective psychological therapies.”
Other specialists in offering talk therapies include psychotherapists and counsellors along with specialist mental health nurses. Currently there are 516 registered psychotherapists and also about 2500 counsellors (working in education, health, social welfare, private practice and other settings) are members of the New Zealand Association of Counsellors (NZAC)which is the largest of the several self-regulating counselling associations setting professional standards for their members. There are also about 700 doctors registered as psychiatrists working in New Zealand.
The Association’s youth mental health spokesperson, Christine Macfarlane, welcomed the Inquiry report and called for the Government to prioritise urgently increasing the funding for school guidance counsellors. She said the Inquiry report recognised the growing need for access to mental health services for children and youth and that preventative and early intervention was crucial.
“So, it’s important that government invest funding into access to talking therapies through primary, intermediate and secondary schools, and action should be taken sooner rather than later.”
Stewart said psychological therapies (also called talking or talk therapies) were important to help people recover from many mental health and addiction difficulties, and prevent difficulties from becoming more serious.
“Psychological therapies can also address the causes of difficulties rather than only looking at the symptoms, which is vital for long-term improvement in quality of life and wellbeing.”
He said therapies can be offered to individuals, couples, families or groups – and in New Zealand were typically evidence-informed, that is, based on research that had shown they were effective.
“Contrary to how they are sometimes portrayed, psychological therapies are often brief, and focused on making rapid and meaningful change in people’s lives.”