Skilled Occupation List (SOL)

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Skilled Occupation List (SOL) 2015-16

Tracking Code:

N2AZ94

Name

Sabine Hammond Individual *

Australian Psychological Society Organisation

What are the industry/industries and ANZSCO occupation/s that you or your organisation represents for the purposes of this submission?

Professional

Education and Training

Health Care and Social Assistance Industry

Occupation

The three dropdowns below accord with the ABS ANZSCO classification of occupations.

Selections are required at the ‘Occupation Group’ 2-digit level and at the ‘Occupation Unit (4-digit)’

level, but can also be made down to the Occupation (6-digit) level depending on the occupation/s to which your submission relates.

Additional occupations can be selected by way of the ‘Add item’ button.

For each occupation selected, please indicate whether your advice is to Include, Exclude, or is Neutral (other) with respect to the 2015-16 SOL. The rest of the form can be used to provide evidence/reasons to support your recommendations. Attachments can also be added after clicking the 'Submit' button.

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Item 1

Legal, Social and Welfare Professionals Occupation Group *

Psychologists Occupation Unit *

Psychologists nec 272399 Occupation

Summary advice for 2015-16 SOL *

Include Exclude Neutral

Item 2

Clinical Psychologist 272311 Occupation

Item 3

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Educational Psychologist 272312 Occupation

Item 4

Organisational Psychologist 272313 Occupation

Item 5

Psychotherapist 272314 Occupation

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Are there any occupations that you represent where there is evidence of imbalances in the demand for and supply of skills in the medium-to-long term? *

For psychology, there will be an imbalance in the demand for and supply of psychologists in the medium-to-long term. It is expected that there will be an imbalance with respect to the

psychologists (nec 272399), educational psychologists (272312), organisational psychologists (272313), and possibly clinical psychologists (272311). Note that the terms psychotherapists (272314) does not refer to a registered profession and can include various training backgrounds.

As stated in previous submissions, "psychotherapist" should be excluded from the ANZSCO Unit Group 2723: Psychologist.

The Australian Psychological Society (APS) is the largest professional association for psychologists in Australia, representing more than 21,000 members (1). The membership includes approximately 60% of the total number of registered psychologists in Australia. The APS database provides evidence that psychologists work in all sectors of the workforce: public, private and non-government organisations. Psychologists also work in a variety of settings including hospitals, health centres, private clinics, community services, welfare organisations, schools, corrections facilities, higher education providers and research centres, and human resource organisations. Psychologists provide professional services to individuals ranging from young children through to the elderly, and to couples, families and organisations. The demand for psychologists thus varies depending on the sector and context in which a psychologist is engaged, as well as the geographical location.

According to the Psychology Board of Australia, there were 26,219 fully registered and practicing psychologists in Australia (2) in June 2014. The major areas of demand for psychologists in the medium-to-long term include mental health and chronic disease. In 2003, mental health

disorders represented the third highest burden of disease in Australia accounting for 13% of the total burden of disease across the nation (3). Almost half (45%) of Australians will experience a mental illness in their lifetime (4). The World Health Organisation (WHO) estimates that

depression will be the number one health concern in both the developed and developing nations by 2030 (5). The evidence is clear that there will be an increasing demand for evidence-based interventions to address mental health disorders in the medium-to-long term in Australia.

Psychologists are highly trained professionals skilled in the delivery of evidence-based psychological interventions for the management of mental health symptoms and disorders.

The 2004-05 National Health Survey showed that just over 7 million people in Australia have at

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least one chronic health condition (6). The Australian Institute of Health and Welfare (AIHW) indicate that chronic illnesses are one of the leading causes of mortality in Australia. Many chronic illnesses have substantial behavioural components and the AIHW recommend that behavioural risk factors (e.g., smoking, diet, a sedentary lifestyle, stress, drug and alcohol use) be the main focus of efforts in the area of health promotion and disease prevention.

Psychologists are skilled in the delivery of psychological interventions to address the impact of behaviours on health, as well as the impact of illness on psychological wellbeing. Given the high incidence of chronic illness in Australia and the ageing population, the expected demand for psychologists to work with people with chronic illness and to provide training and support to other health professions is likely to increase in the medium-to-long term.

While the demand for psychologists is likely to grow, current data indicates that the supply of psychologists is declining and likely to continue to do so. There are two routes to registration as a psychologist in Australia. One route involves four years of accredited study in psychology followed by further professional training at the postgraduate level. However, the number of

professional postgraduate courses has been declining over the period 2006-2010 such that there are more eligible candidates than postgraduate psychology training places (about 2.6 candidates apply for each place)(7). Only 7.8% of the total undergraduate psychology intake completed postgraduate study in 2008, 8.7% in 2009 and 8.4% in 2010(8). This situation is predicted to continue as the declining number of places is related to the funding structure for postgraduate psychology programs. Many higher education providers have discontinued to range of

postgraduate programs in 8 of the 9 areas of practice in psychology, mostly for cost reasons, and are focussing principally on postgraduate training in clinical psychology.

The alternative route to registration is through an accredited sequence of study (4-5 years) followed by an internship (1-2 years). This pathway has been significantly affected by changes to the requirements for completion of an internship that has made internships an unattractive option for the both the public and non-government sectors. Consultations undertaken by the APS with a range of organisations, students, and supervisors indicates that internships are no longer a viable a means to train psychologists within a reasonable timeframe and cost.

In summary, there will be an imbalance in the demand for and supply of psychologists in the medium-to-long term.

1 Including both psychologists and non-psychologists 2 http://www.psychologyboard.gov.au/About/Statistics.aspx

3 Begg, S., Vos, T., Barker, B., Stevenson, C., Stanley, L. & Lopez, A. (2007). The burden of disease and injury in Australia, 2003. AIHW cat. no. PHE 82. Canberra: AIHW.

4 Australian Bureau of Statistics (2009). National Survey of Mental Health and Wellbeing:

Summary of

Results, 4326.0, 2007. ABS: Canberra.

5 World Health Organisation (2008). The global burden of disease: 2004 update.

6 http://www.aihw.gov.au/chronic-diseases/

7 Voudouris, N., & Mrowinski, V. (2010). Alarming drop in availability of postgraduate psychology training.

InPsych, 32(2), 20-23.

8 Department of Industry, Innovation, Science, Research and Tertiary Education [DIISRTE].

(2011).

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Students: Selected Higher Education Statistics, Full Year 2008-2010. Canberra: DIISRTE.

Is there evidence of imbalances in the demand for and supply of skills in the medium-to-long term in non-metropolitan areas?

If so, can you indicate in what part of Australia and the number in the occupation in over or under- supply.

There is evidence of imbalances in demand pressures and supply blockers in regional, rural and remote Australia. These are likely to continue to escalate in the medium to long term.

Evidence for demand: The AIHW states that people living in non-metropolitan areas, especially remote areas, experience higher death rates and poorer health outcomes than those living in metropolitan areas (1). There are multiple reasons for this discrepancy including higher rates of behavioural risk factors (e.g., smoking, diet, stress, drug and alcohol use, physically dangerous work, help seeking behaviours). There are also high levels of psychological distress and mental illness in rural areas, particularly for men (2). There is thus a growing demand for evidence- based psychological and behavioural interventions outside urban areas, especially in the more remote locations.

Evidence for supply issues: The rural health workforce crisis is well documented, including the shortage of mental health professionals (3). Approximately one-third of Australians live outside major cities, with 20% in inner regional, 9% outer regional, 2% remote and 1% very remote (4).

However, in 2012, approximately 82% of psychologists worked in major cities, 12% in inner regional areas, 5% in outer regional locations, and 2% in remote/very remote locations (5). The supply of psychologists in Australia thus ranges from 98.6 FTE per 100,000 population in major cities to 34.0 FTE per 100,000 population in remote/very remote regions (6). The blockages to the supply of psychologists outside metropolitan regions are similar to those described in our answer to the previous question.

These blockages are magnified in non-urban regions because of the reliance on the internship pathway to produce the rural workforce and the lack of access to postgraduate training for people living in rural regions. Furthermore, the existing workforce shortage impacts on the capacity for student placements and internships to occur in non-urban regions (because they require supervision by a fully trained psychologist), in turn impacting on the future rural workforce pipeline.

1 http://www.aihw.gov.au/rural-health-impact-of-rurality/

2 AIHW (2008). Rural, Regional and Remote Health. Cat. no. PHE97. Canberra: AIHW.

3 Health Workforce Australia (2013). National Rural and Remote Workforce Innovation and Reform Strategy. Adelaide, SA: HWA.

4 AIHW (2013) Accessed from http://www.aihw.gov.au/rural-health-demography/

5 AIHW (2012). Allied Health Workforce 2012. Cat. no. HWL 51. Canberra: AIHW.

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6 ibid

Are there any occupations which require formal licensing or registration arrangements in order to practice/perform in this occupation?

For example:

• Midwives are required to register with the nurses board in their state or territory

• Panelbeaters are required to be registered or certified with the state Motor Vehicle Repair Industry Authority

The psychology profession is subject to statutory regulation under the Health Practitioner

Regulation National Law Act ('the National Law') in all Australian states and territories. Under this National Law, the title psychologist and its derivatives are protected. All psychologists must be registered with the Psychology Board of Australia (PsyBA).

The following occupations require registration: Psychologist nec 272399, Clinical Psychologist 272311, Educational Psychologist (272312), and Organisational psychologist (272313).

Psychotherapy and psychotherapists, unlike psychologists, are not subject to statutory regulation and their titles are not protected. Individuals who identify themselves as a "psychotherapist" may or may not have had the training required of a registered psychologist.

The APS recommends to exclude "psychotherapist" 272314 from the ANZSCO Unit Group 2723 Psychologist. This is consistent with the aim of the National Law to ensure that only practitioners who have the skills and qualifications to provide safe care and psychological services are

registered to practice in the psychology profession.

The APS recommends to include as listed occupations the other 6 areas of practice, recognised by the PsyBA and also protected titles, that are not on the skilled occupations list: These are: (1) clinical neuropsychology, (2) community psychology, (3) counselling psychology, (4) forensic psychology, (5) health psychology, and (6) sport and exercise psychology.

Is it expected that your employment sector will be impacted by any medium-to-long term trends which will impact upon demand and/or supply (excluding costs

associated with training, labour hire, and international sponsorship)?

Please provide evidence (e.g. data source, policy document) which substantiates these claims.

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For example:

• New benchmarks for childcare centres mandate increased staff-to-child ratios and higher qualification standards for childcare workers.

Demand: As stated above, demand for psychological services is expected to increase, reflecting predictions of increased burden of disease, especially related to mental health, chronic illness, and the needs of an ageing population. With government focus on evidence-based practice and demonstrated outcomes, the psychology profession is uniquely qualified to address these demands.

Supply:

- As stated above, the supply of psychologists is affected by the decline in availability of

pathways to registration, especially the decrease in postgraduate training places both overall and in specific areas of practice both included and currently not included on the skilled occupations list (such as educational and developmental psychology or sports and exercise psychology).

- It is difficult to anticipate to what the effects of the current proposed higher education reforms will be but there is the possibility that increased student fees will affect the number of students enrolling in postgraduate programmes in psychology.

- Ageing psychology workforce: approximately 34% of the registered psychology workforce are aged 50 and above (1), including a small percentage (7.8%) of psychologists above age 65.

Another 8.1% of this workforce will be of retirement age by 2020 and a further 9% by 2025. With the current available higher education places, the retiring workforce may not be replaced in sufficient numbers to maintain the current supply, let alone increase the number of psychologists.

(1) http://www.psychologyboard.gov.au/About/Statistics.aspx

Please provide any other information you consider relevant evidence to support your submission

For example, you may know of some independent studies about your occupation that supports your advice to us.

Would you like to make any additional comments on the SOL?

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The APS has raised these issues in previous submissions. The APS is concerned that some of the material included in the Occupation Summary Sheet for Psychologists is incorrect and would like to take this opportunity to address these errors.

1. In the summary sheet it states that "4 years minimum study is generally required in university courses leading to the occupation".

The APS recommends that Table 2b (the paragraph on Long Lead Time) be amended to read:

“A minimum six-year sequence of education and training in psychology is required for an individual to become eligible for general registration with the Psychology Board of Australia”.

Explanation:

(a) Higher education providers other than universities are now offering accredited psychology programmes.

(b) To become a registered psychologist in Australia requires 6 years of study and practice that can be obtained through multiple pathways:

- A 3-year Australian Psychology Accreditation Council (APAC) accredited sequence of study in psychology (e.g. a bachelor degree majoring in psychology); followed by:

- An APAC accredited 4th year in psychology (e.g. honours, postgraduate diploma) (some

programs combine 1 above and this year together into a four year program); followed by either: a 2-year APAC-accredited postgraduate psychology program (Masters level at least); or an APAC- accredited fifth year psychology program (e.g. graduate diploma of professional psychology) followed by 1-year full-time Psychology Board of Australia (PsyBA) approved supervised practice as a provisionally registered psychologist; or iii. years full time PsyBA approved supervised practice as a provisionally registered psychologist.

These pathways form the basis of the educational and training requirements against which overseas-trained psychologists are compared to determine their eligibility to obtain registration to practice as a psychologist in Australia.

2. Psychotherapy may be a method of therapy used by psychologists, but psychotherapists are not qualified to provide the whole range of skills in which psychologist is trained. The label

‘psychotherapist’ is not recognised nor regulated by the Psychology Board of Australia (see response to Question 5 above).

Therefore, the APS recommends the removal of 272314:Psychotherapist from the ANZSCO Unit Group 2723: Psychologist.

3. The APS notes that the list of occupations under Psychologists for ANZSCO Unit Group 2723 is not consistent with the titles approved for use by psychologists under the National Law.

The APS recommends that the list under 2723 Psychologists be amended to include these additional titles acceptable under the National Law for use in Australia: Clinical

Neuropsychologist, Community Psychologist, Counselling Psychologist, Health Psychologist, Forensic Psychologist, and Sports and Exercise Psychologist.

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Please provide the name, position and contact details of a person within your organisation who is willing to be contacted if any further information or follow-up is required.

Dr Sabine Hammond Name *

Executive Manager, Science, Education and Membership Position *

P.O. Box 38

Flinders Lane, VIC 8009 (03) 8662 3300

[email protected] Contact details *

All information, including name and address details, contained in submissions will be made available to the public on the Department of Industry website unless you indicate that you would like all or part of your submission to remain in confidence. Automatically generated confidentiality

statements in emails do not suffice for this purpose. Respondents who would like all or part of their submission to remain in confidence should provide this information in an email to SOL@industry.

gov.au . Legal requirements, such as those imposed by the Freedom of Information Act 1982, may affect the confidentiality of your submission.