With 2022 being a year where there was a federal election in addition to the annual handing down of the federal budget, the Australian Association of Psychologists Inc (AAPi) and Australian Psychological Society (APS) have both been advocating for the profession.

Pre-budget submission

The AAPi pre-budget submission for the 2022-2023 federal budget focused on 4 items:
1. A one-tier Medicare rebate system for the clients of all registered psychologists in Australia, replacing the current two-tier system
2. Raising the Medicare rebate to $150 per 50 minute session
3. Implementing the Productivity Commission recommendation for up to 40 rebated sessions for clients each year
4. Establishing a provisional psychologist Medicare rebate

Post-budget

Following the handing down of the federal budget, AAPi Executive Director Tegan Carrison said it was unfortunate that the budged only allowed for an additional $648 million in spending for mental health.

Ms Carrison stated that “Some of the positive budget announcements include:

• Funding towards workforce development
• Continuation of item numbers for bushfire victims and the additional funding for mental health care of those impacted by the floods
• Mental health support for vulnerable community members, including Aboriginal and Torres Strait Islander people, multicultural communities and victims of domestic violence
• Permanent telehealth

“AAPi also welcomes the much-needed investment in suicide prevention, eating disorder treatment and services such as crisis lines, but more is needed to ease the escalation of our mental health crisis and support our existing and future mental health workforce.

“We are happy to see that our calls for more investment and support of provisional psychologists have been noticed – with 75 internships for provisional psychologists announced and support for the safe use of the provisional psychologist workforce to deliver services, and the provision of 150 free Psychology Board of Australia endorsed supervisor training sessions – the question remains as to whether this will lead to more psychologists achieving full registration.

“We have a serious problem in that the measures announced don’t fully address the elephant in the room: a workforce that is smaller than demand, areas of psychology facing extinction, and insufficient rebates for the majority of Australians.

“Too much of this budget is a band-aid solution, and the stakes are too high for that. As a nation, our mental health has been collectively challenged like never before. The frustration of getting help when we really need it is wearing us thin and those providing the help are even more fed up. Our late 2021 Private Practice Survey showed 78% of clients exhibited more distress, anxiety, or depression, with 47% of psychologists unable to take on new clients.

“This Budget did not address AAPi’s key concerns with regards to workforce shortages and chronic underfunding of pivotal services such as Medicare, rural and remote services and school psychologists. Without raising the Medicare rebate to $150 for the clients of all psychologists, access to affordable mental health care remains out of reach for hundreds of thousands of people.

The APS expressed disappointment in the budget, but stated that there were some welcome announcements.

APS President Tamara Cavenett said ““The government is only meeting 35% of their workforce target while one in three psychologists are unable to take on new patients. Before the pandemic, it was 1 in 100.

“Making university funding on par with dentists, GPs, psychiatrists and veterinarians is critical to the future of the psychology in Australia. The government can’t deliver on its promises without the workforce to back it up.

“Despite record demand to see a psychologist and worsening cost of living pressure the budget fails to reduce gap fees for people in crisis and contemplating suicide.
“We needed a budget that lowered gap fees and got psychologists into schools and the regions. Sadly, the opportunity has been missed.

The APS also felt that the following reforms were crucial, and had not been addressed in the budget:

• Funding university places on par with GPs, veterinarians, dentists and psychiatrists
• Committing to the 1:500 psychologist to student ratio at all public, private and independent high schools in line with the government’s Mental Health and Suicide Prevention Inquiry
• Expanding Medicare coverage and lowering the gap fee for patients
• Providing regional relocation incentives to psychologists on par with GPs, and
• Making the additional 10 per annum Medicare-funded psychology sessions a permanent feature of the Better Access program

Pre-federal election

In the lead up to the federal election, the APS called on all parties to commit to ensuring that Australians in regional, rural and remote areas do not have to fend for themselves instead of being able to access mental health support.

The APS quoted a figure of 20% of psychologists being in regional Australia servicing the 28% of the population who live there.

APS President Tamara Cavenett said “Your postcode should never determine your mental health, yet we continue to see 7 million Australians, in some of the most disadvantaged parts of the country, left to fend for themselves.

With some of the highest rates of alcoholism, depression, self-harm and suicide found in regional, rural and remote Australia, how long will the government stand by and continue to think this is good enough?

“These people put food on our plates, clothes on our backs and power our homes but we can’t help them when they’re at their lowest ebb? This national shame must be brought to light.

The APS stated that the Federal Government was meeting only 35% of its psychology workforce target, the largest shortfall of any mental health workforce and, that unlike GPs, there are no incentives for psychologists to relocate to regional areas.

Ms Cavenett said “GPs save lives each day and deserve the support they get, but we have to address the mental health deserts sweeping across regional Australia during the shadow pandemic.

“In regional, rural and remote Australia many people are lucky to simply get onto a wait list, and even then wait times of more than 12-months are common in some areas.

Also in the lead up to the election, the APS developed a 10-point election manifesto:
1. Invest in a surge workforce to ensure effective disaster readiness and response
2. Perinatal mental health for all Australian parents
3. Get psychologists into schools
4. Support child mental health hubs
5. Introduce a youth mental health safety net
6. Ensure COVID-19 mental health recovery through bulk billing and rural incentives
7. Improve digital mental health services
8. Future-proof the psychology workforce
9. Strengthen the psychology workforce
10. Get graduates to clients faster

Post-federal election

AAPi released an association update following on from the federal election. It stated that the association members had reached all election candidates a number of times with their key advocacy items for a more accessible and fair mental health care system.

Following the federal election, AAPI Executive Director Tegan Carrison stated that “AAPi has built strong relationships over the years with all sides of politics and will continue these conversations with the incoming ministers, advocating for our shared vision for mental health care in Australia.

“With the new Labor government foreshadowing a focus on Medicare, NDIS and aged care, there has never been a more important time for AAPi to take the lead in advocating for an equitable and diverse psychology profession.”

The APS urged the Albanese government to commit to addressing mental health challenges faced by Australians, and congratulated Ministers Butler and Clare on their appointments (Health and Aged Care, and Education, respectively).

APS President Tamara Cavenett said ““During a time of uncertainty and national crises our mental health system is on the brink. Psychologists on the frontline are telling us the anxiety that people are feeling about climate change and natural disasters is palpable right across the country.

“We are committed to working with the incoming government to create a more sustainable sector that values patients and psychologists alike.

“By increasing university funding we can begin to address the problems facing the community.”

In June, the APS welcomed the federal government’s announcement to an overhaul of the national school chaplaincy program, stating that they saw it as an opportunity to implement the ratio of 1 psychologist to every 500 students.

With the news that schools would be able to choose between hiring a religious or secular pastoral care worker, APS President Tamara Cavenett said “Investment of government funds into placement of qualified mental health experts such as psychologists into schools just makes sense.

“The APS has raised significant concerns over many years about the national school chaplaincy program. We’ve repeatedly stated that while we are not opposed to the presence of chaplains in schools for pastoral care, the investment of scarce government-funded resources should be redirected to professional qualified experts, such as psychologists.

“This is a step in the right direction for evidence-based pastoral and mental health care for Australian school students. It is common sense, and it is entirely appropriate.

“Young Aussies have experienced turmoil, uncertainty, and major disruption to their schooling and major childhood milestones over the past two years. Never has it been more important to ensure they are receiving mental health care from qualified experts.

“Fifty per cent of lifelong mental health issues start before the age of 14 years, so school is the appropriate setting to catch early signs and provide early intervention.
“For many years we have been urging the Federal Government to develop a national benchmark for school-based psychologist to student ratios.

“Evidence shows by aiming for a benchmark of 1 psychologist to every 500 students would benefit the whole school community an provide vital support to teachers, principals and families.

“Psychologists employed in schools work at a whole-of-school level on programs to support children’s’ mental health, development and learning. The benefits of access to a psychologist at the right time, can be seen for years to come. It simply makes good economic sense to look after the mental health of our children.

“Psychologists can assess children for mental health issues, learning difficulties, intellectual disability, and can work with teachers and families to support children with behavioural issues and learning difficulties” said Ms Cavenett.