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Friday, November 1, 2024

Point of Order: Buzz from the Beehive - 1/11/24



Overseas psychologists are ruled out from treating us on cultural safety grounds – so the govt is lowering the bar for Kiwis

When you don’t have enough trained health workers to cope with the demand for help – what should be done?

Pave the way, perhaps, to approve practitioners with lesser credentials than those who now provide services.

Mental Health Minister Matt Doocey took time out from dealing with the Mike King brouhaha to announce that applications have opened for tertiary education organisations to seek Government funding to develop New Zealand’s first postgraduate diploma programme for “associate psychologists”.

Doocey apparently has plenty of dosh for spending on mental health services.

He has been defending using some of itto fund the Gumboot Friday counselling programme after Mike King said alcohol could be “the solution” to some people’s problems.

We don’t know about King’s qualifications, but Doocey isn’t ready to pull the plug on Gumboot Friday.

He is ready to recruit “associate psychologists” and develop processes to determine the scope of their practice, competences and accreditation.

He explained:

“Several hundred psychology students graduate every year with undergraduate degrees, with many wanting to undertake postgraduate studies but are unable to because of the very restrictive postgraduate pathways.”

Restrictive?

Does that mean competent graduates are being unreasonably or vexatiously barred from becoming practitioners – or that many graduates simply aren’t competent enough to pass muster with the authorities who set eligibility standards?

An RNZ report earlier this year provided an explanation.

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.


He should have mentioned this in his press statement, which can be found on the government’s official website today with a few other items of health news and an announcement of Foreign Affairs Minister Winston Peters heading for Australia.

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In his statement, Matt Doocey said guidance on the role and training is still developing, but

“… the vision is that associate psychologists will be registered health professionals with regulatory oversight from the New Zealand Psychologists Board.

“The associate psychologist will hold a postgraduate qualification and, under the supervision of a registered psychologist, will support those who are accessing mental health services.

“The new role will also enable registered psychologists to focus on more complex cases and use their full scope of practice.”


But won’t registered psychologists be busy keeping an eye on the associates?

Doocey didn’t address that question, but he said the programme aims to help ease New Zealand’s mental health and addiction workforce shortage.

“We know that time spent on a waitlist is a risk factor and the ability to been seen in a timely manner can greatly reduce a person’s mental health from deteriorating. That is why it is crucial we put new initiatives like this in place to grow the workforce.”

The goal is to establish a training programme beginning with at least 20 associate psychologists in the first year, with the first cohort of students expected to start their one-year postgraduate study in 2026.

The Request For Proposals for funding to develop this new training programme is now open on the New Zealand Government Electronic Tenders Service (GETS).

We learn more from a briefing paper, dated 12 April 2024 and titled Developing an Associate Psychologist Workforce in New Zealand.

It said substantial gaps in our mental health and addiction workforce present a significant barrier to increasing access to services and providing optimal models of care.

In September 2023, the vacancy rate for psychologists in Te Whatu Ora was 19%.

Due to current demands on services, many people were waiting for psychological services or were missing out altogether.

“Establishing effective, appropriate frameworks/models of delegation would enable registered psychologists who are employed in mental health and addictions settings to most effectively utilise their full scope of practice.”

The proposed establishment of an associate psychologist role would allow individuals with a suitable undergraduate qualification to enter a further period of training (proposed to be a one-year post graduate diploma) so they might be registered with New Zealand Psychologists Board and employed in roles that provided support to the delivery of psychological services.

“The proposed approach would draw on the large numbers of psychology undergraduates who are interested in working in health but who do not achieve entry into the currently available highly restricted training that leads to registration as a psychologist. In 2022 there were just 156 new New Zealand-trained registrants across all five scopes of practice.”

What about shipping in psychologists from overseas?

Good idea – except they don’t pass muster when it comes to cultural safety.

“While there were a further 70 overseas applicants registered (most with conditions), the Board has reported that overseas trained applicants struggle to demonstrate the skills and knowledge required to provide culturally safe services to Māori.”

Better care for Maori apparently is being addressed through the concept of associate psychologists.

The briefing paper says Māori experience significantly higher rates of mental illness than non-Māori. However, Māori practitioners are under-represented in the psychology profession.

“In developing the associate psychologist qualification there is an opportunity to establish training pathways that provide cultural worldviews and models of health and wellbeing which will benefit populations with the greatest need and provide a pathway to other registered scopes of practice for Māori practitioners.”

The briefing paper further says work on developing an associate psychologist workforce had previously been under consideration in New Zealand.

In 2019, members of the Ministry of Health-led Psychology Workforce Task Group developed a proposal for a similar role of “psychological wellbeing practitioner,” based on a United Kingdom model.

Hmm. Won’t there be a strong whiff of something disagreeable to certain parties in this country if we adopt British ideas?

Indeed there will. The briefing paper says this model was consulted on and received mixed reviews from the sector, particularly from Māori health leaders “who had significant concerns that the English model did not include a Mātauranga Māori approach and would not be fit-for-purpose in New Zealand.”

Point of Order is a blog focused on politics and the economy run by veteran newspaper reporters Bob Edlin and Ian Templeton

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