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Electric Wrigglies posted:heh, when I first seen the scheme, my first thought was "huh, this will be great, psychologies can just focus on the patients they like, overservicing them at the expense of new and remote patients" Ehhhhhhhhhhh not sure if I agree with this take. The 20 sessions in of itself is not the reason why people can't see psychologists. The reason is because we don't have enough psychologists to service the current demand because the training pipeline for psychologists is absolutely hosed. People may be aware that it's not easy at all to become a psychologist, what the general public may not be aware of is that changes to how psychologists trained which came into force midway this year. Previously, we had both a "4+2" which is an apprenticeship style training regime where people did the 4 year Honours degree and then practiced semi-independently as provisional psychologists and then the "HDR" route which is a masters involving practicums, coursework, and research. Concerns had been raised about the quality of the training provided in the 4+2 and how it's a bit exploitation-y so as a result it got the rear end and replaced nominally by a "5+1" which has an extra year of coursework which leads to a final year closer to the apprenticeship. This would aim to address concerns about standardisation of training while not requiring the same amount of academic resources of a standard Masters. The issue is about the volume of training offered by the different pathways. Take for example QLD, where theres something like 400 provisional psychologists across all HDR pathways (Ahpra is down so I can't verify) and something like 800 4+2 provisional psychologists. With the phasing out of the 4+2 pathway, the 5+1/HDR pathways will need to surge to meet this demand. I really don't think that we've had sufficient investment into supporting institutions to create, certify, and staff the new training pathway meaning that we have, in the near future, a degraded ability to train psychologists. This is a bit anecdotal but I've heard that this years intake for psych postgrads has been the worst yet as now everyone has to effectively apply to a university given that you have very, very few options for 5+1s currently (although this may change in the future). The other "lol" is that we have a two-tier system for registering psychs and recognising their experience. If you do an HDR psych masters, you can typically get endorsement in a certain area (e.g., clinical) which actually has ramifications from a medicare point of view. Clinical psychs get a better medicare rebate and I think from memory there is some other stuff they get which is sick but it also means that the HDR/Clinical pathway is extra competitive because you can only get endorsement currently if you did the masters, if you did a 4+2, you are poo poo out of luck and you top out with general registration. This exact reason is why we have huge splits in psych as there is a constant slapfight between clinical psychs and everyone else. It also means that the HDR pathway gets a stack of people who were 4+2 provisional psychs or generally-registered psychologists applying and getting in. From the programs I've seen the numbers into, about 25% of the candidates already posses some level of registration as a psychologist. This means there is an inefficiency factor being introduced as we aren't training X number of psychs, we are actually training X * .75 of psychs meaning that we are getting less bang for our buck. Legislatively, there are mechanisms to allow for bridging courses etc. but don't think institutions really offer it much.
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Dec 12, 2022 10:29
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The tl;dr is that we have a system "designed" by a bunch of people who never had to go through the hoops that currently-trained psychs have to go through and it really ratfucks us and society/people that rely on it. If the ALP had announced greater funding to address how psychs are trained then maybe it wouldn't have been such an issue but again it's a combination of psychs that are counselling/clinical are poo poo at self-advocacy and the ALP being dumb as gently caress.
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Dec 12, 2022 10:32
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Electric Wrigglies posted:Thanks, really good explanation. I think the tiered system we see in psychology is something which is related to, but a bit distinct from the issues around the removal of the extra 10 sessions from BAS. The line from the ALP is that the extra sessions are just clogging up the system and people aren't able to see psychs because people have 20 sessions and not 10. The issue was that even prior to COVID, it was difficult to see a psych due to waiting lists and one of the biggest barriers to access was cost. While the greater demand for MH support has meant a greater demand for psychs, medicare still doesn't cover the cost of seeing a psychologist so clients still have to stump up money they may not have to see a psych. Sure, clinical psychologists get a better rebate but they will also charge more as the training can be expensive and there is a level of "prestige" attached with being a clinical psychologist. It's no accident that a lot of clinical psychs/registrars will go into private practice ASAP and target middle/upper class demographics as that is where the money is. You then find that a stack of psychs who work on the tip of the spear of MH either don't have endorsement, come from a 4+2 pathway, or are a provisional psych as there is very little funding in providing serious acute MH support so really I'd even argue that we have the system somewhat backwards, the people with the greatest level of training in clinical psychology often don't even stay in that acute space because there's no incentive. IIRC the review into the BAS did not recommend the sessions be cut, because it's a loving idiotic move but also not surprising as Mark Butler hates psychologists. The primary issue is not that patients are having "too many sessions" (????) it's that over the past 12 years since the overhaul of how psychs are trained/managed we have failed to grow the workforce of psychologists we need to the point that demand outstrips supply. This will only change once we figure out how to convince the government to unfuck the funding/process associated with training psychologists. The whole thing is a bit "robbing Peter to pay Paul" because the effect this may have is just shifting people away from psychologists into hospital EDs which is then a state issue. Extremely classic labor just throwing up the hands on "ah well, what can be done".
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Dec 12, 2022 21:40
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Serrath posted:I hate the Liberal party as much as anyone but I'm forced to acknowledge that the creation of the bulk-billing system for psychology was a Howard policy, sessions were reduced under Rudd, medicare rebate was frozen under Gillard, and then sessions were expanded again under Morrison... now ALP is back in charge and sessions are being reduced again. I don't know why the ALP hates psychology as much as it does but it's not a subtle thing nor a bipartisan thing. This was an excellent post by the way, I wasn't as aware of the pre-2010 poo poo but it definitely contextualises a lot of the poo poo we see today. Before the 2019 election I remember the Australian Psychological Society had appointed a new CEO (Frances Mirrabelli??) and was doing the rounds to both signal change (which never eventuated and she got the rear end) as well as outlining the advocacy being done on both sides of politics. She flagged with the members at the time that she thought we would have a change of government in 2019 (lmao) and that psychology was not in a strong position with the ALP because of the long-standing dislike of psychology in addition to a lot of the splits we seem to have within the profession. I remember at the time the CEO stated that we really need to consider how to we unfuck the internal dynamics so we can better advocate for ourselves but as stated earlier that CEO left under some pretty tight-lipped circumstances but there's been very little change since. That's really where my understanding of "the federal ALP seems to hate psychology" comes from. Despite the ALP losing that election and seemingly would need to rethink the strategy, I'd love to hear the justification from the terminal ALP-brains on why this is a cool and good thing and why it seems to continue to happen under Labor governments.
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Dec 13, 2022 22:33
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Serrath posted:
I think it's actually really good to chuck it all on the table. I came across an opinion by a ALP-er to the effect of "the only people caring about this change is the people in the industry" and that really resonated with me, basically because there's really little visibility on how loving insane the whole situation within psychology is outside of the profession. What was a seismic shift in the way psychs were trained (the axing of the 4+2) didn't register at all outside the profession because it's just a huge mess. quote:The following is my own personal opinion but I strongly feel that this 10-year civil war is reducing the capacity of psychology governing bodies to advocate for themselves. I've been to conferences where panel discussions are hosted for public debate, debates about the number of sessions allowed under the better access scheme might take 5 minutes and be quite civil and then you get to the agenda item of talking about doing away with clinical-psychology specific medicare billing numbers and suddenly people are shouting at each other, walking out, throwing tables, and nothing else gets discussed. And while the profession of psychology tries to reconcile this debate, policy changes like the medicare freeze and reduction in better-access sessions gets reduced without any real challenge. I can't bold this enough. You really hit all the points I could make more eloquently but I completely agree with this. Resolving this schism will also allow us to focus on non-counselling and clinical psychology (like Organisational, Sport, Health, Ed/Dev, Forensic) which basically get chucked to the wayside and don't get any advocacy/playtme. In some cases we lost one of the few organisational psych programs because I really feel we gently caress around and do ourselves, and society, a disservice. Any goons who have read this far and actually feel something please write to your local MP about what the gently caress happened to those extra sessions because I do believe it's just widening the gulf between people who can afford mental healthcare and people who roll the dice in either taking the 10 sessions a year or potentially have to wait until they are extremely, extremely acute and go inpatient. The cost of treating people in a MH inpatient service far outweighs the cost of the BAS so the whole situation is just loving dumb.
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Dec 14, 2022 06:34
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MikeJF posted:Mine pleasantly seems to already have converted. That's good but hoooooly poo poo why the hell is the government doubling down on not reversing it, seems like an own goal.
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Dec 14, 2022 10:18
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Tokamak posted:the psych vs. clin. psych distinction seems like some real crab bucket mentality. Yeah well everyone at the end of their training gets generally registered, so it's actually a single tier. The "special sauce" is the area of practice endorsement or endorsement for short, which is where you get titles like organisational/clinical psychologist. At present, the only people who are eligible to undertake the further training for endorsement are people who have gone through the specific masters although there was a reasonably recent VCAT ruling which suggests that the system as-is isn't consistent with the spirit of the legislation where endorsement is supposed to recognise a particular depth of knowledge and experience. As everyone gets streamed in psychology presently the masters are absolutely brutal to get into. The stats I've seen out of the APS suggest something like 25-50% of honours graduates get into some form of psych postgrad eventually, but that doesn't account for the fact that honours degrees accounts for something like the absolute top 5-10% of psychology students. Everyone applies everywhere basically, but it's not uncommon for clinical programs to have like 500-700 applicants for like less than 20 places. This experience, paired with a healthy dose of institutional elitism, forms a lot of what I see as the splits as it's like an identity. If I had to point fingers towards who's responsible, I'd say that a stack of (but not every) pre-2010 psychologists didn't really give a poo poo and weren't looking to the future of the profession meaning some very suboptimal choices were made. It squares away with the same issues of self-advocacy that we see today but due to that super academic background in psychology I just don't think we thought it mattered back then.
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Dec 14, 2022 20:50
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lih posted:it's just a cut labor think they can get away with because access to psychology is already so hosed that the cuts will probably just kinda shift around the problem a bit rather than being definitively worse overall (although it's definitely worse in principle and does nothing to address the underlying issues) & labor already have some weird issue with psychology to begin with evidently I'll shut up about the psych poo poo after this but the risk arising from this decision is that we pull the ladder of mental healthcare up slightly again, meaning a stack of people who may have been able to afford those gap payments will not get treatment and are left to the winds of fate. Will they get better by themselves? Will they experience a decline enough to require acute services (a huge and extremely negative outcome)? Somewhere in the middle? It's a bit ghoulish by Mark Butler to cite "... the need to do more to support people in rural and low socio-economic areas" but also reduce the ability for those people to access psychological services without announcing additional support. This decision literally only impacts the consumers of mental health services. Everyone I know has a stack of work, and they had a stack of work prior to COVID too so really Ranter posted:Labor's cutting it because they're confident they're going to fix the root cause of the spiralling mental health crisis. Bonus, it's also going to stop further climate change and imperialism. It was difficult, took a lot of work and time, but I'm really glad I voted labor.
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Dec 14, 2022 20:58
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sweetroy posted:as someone who is studying psych part time to change careers, this has been an extremely enlightening and somewhat disheartening conversation to read. is there anywhere online where this stuff is discussed that you recommend? I'm not actually sure if there is a great online resource for this kind of thing, unfortunately. My advice is to be a critical consumer of information and basically enjoy the process of learning about psychology. It's hard work and I hope that in the near future we will make it less disheartening!
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Dec 15, 2022 09:21
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Look everyone as we all know the big threat right now are climate protesters and people who inconvenience motorists. Despite this huge security and intelligence apparatus, we can only look at two groups and we've decided that Islamic extremists is always #1 and the current #2 is protesters. It's the price of freedom okay???
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Dec 17, 2022 22:45
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I’m not sure whether there’s been any real announcement but looks like the mental health forum re: better access scheme is happening on the 30/1. Great that it’s happening so quickly but not sure I’m confident in the outcomes as the science of this has already been presented, not sure why it’s got to be a forum.
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Dec 22, 2022 20:44
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Less than 20,000 words on the subject, I'm not convinced.
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Jan 7, 2023 00:39
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Bucky Fullminster posted:Nice casual classism First they came for the bogans, and I did not speak up because I was not a bogan
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Jan 9, 2023 13:18
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I would blow Dane Cook posted:George Pell dead 
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Jan 11, 2023 00:08
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ColtMcAsskick posted:In other news https://www.abc.net.au/news/2023-01-11/man-rape-charges-toowoomba-court/101842830 Lmao I wonder who it is
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Jan 11, 2023 05:39
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It's probably Bruce Lehrmann
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Dressing up as a Nazi wasnt “hip” in 2004 sorry hth
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Jan 13, 2023 21:01
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Bucky Fullminster posted:Hey Auspol here’s the draft of a pitch for a Cycle Network I plan to try and put before the NSW minister for Active Transport, if anyone’s interested or would care to cast their eye over it. Questions, comments, and suggestions welcome. As a consultant, you’ve got too many words on your page. I want to see some slick graphics there mate too sorry this might be good enough for Deloitte but its not up to Bain or McKinsey standards
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Jan 18, 2023 06:21
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Bucky Fullminster posted:The impression I get from Stokes (NSW minister for active transport), is that he might be genuinely interested. I saw him announcing the opening of a cycle way somewhere and he know's what's up. And he was literally asking councils to come to the government with proposals. The problem is, they don't really seem to be looking at how they connect, so we'll end up with a random mish-mash of localised bike paths that don't amount to a viable network. I don’t know why you even asked for feedback tbh based on this response. Leave the detail for the appendix. Give ‘em the slick graphics. The slide deck as is gives me “do you see???” vibes.
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Jan 18, 2023 08:21
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Having so many little fiefdoms in the same metro area feels like it would be a clusterfuck as you'd probably have insane levels of duplication of systems which don't necessarily talk to each other
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Jan 18, 2023 10:28
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No one mention NSW's Gold Standard approach to Covid!!!!!
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Jan 18, 2023 11:57
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maybe the little fiefdoms made sense in ye olden times but i suspect it was starting to not be great in the latter half of the 20th century, and it's completely obsolete in the 21st.Bucky Fullminster posted:
Are you just going to fish for compliments where people slap you on the back and tell you you're a genius? Either take the advice to cut it down/split the deck and make it a LOT less dense or idk just do what you like.
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Jan 18, 2023 20:53
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Bucky Fullminster posted:Well that's my other question, how the gently caress does anything get done in those circumstances? Or is that just part of the reason why so many things suck? there would need to be a significant investment in actually doing the surveying/risk assessments/construction/ongoing maintenance, especially when you are talking about constructing overpasses which are very substantial. Are you a civil engineer or someone who has worked with lobbying? How about writing responses for RFT/RFQs? It's literally why you are being told to cut the detail and make it easier to digest because the aim of the slide deck isn't to give people the detail, it's to starting gathering the political will to do something. Your approach is literally rear end backwards right now.
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Jan 19, 2023 10:57
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Comstar posted:PwC hit with wet lettuce for cheating the people of Australia out out of Billions It's a slight reputational hit for PwC and I'm sure there was some email sent around ensuring that partners actually use the special teams which manage conflicts of interest but not much will actually change here. Theres a lot of focus on isolating the audit components from the consulting components in the Big 4 (IIRC at least one Big 4 spun off it's management consulting arm in an attempt to de-risk) but what's harder is when you have clients with potentially competing interests. It's why we have the many consulting firms as not one single firm can manage such a huge variety of competing interests but normally it's better managed than this.
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Jan 24, 2023 09:25
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Solemn Sloth posted:Here’s a radical idea, what if government retained some kind of capability for policy analysis and development within the public service they do, it's just not very good
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Jan 24, 2023 11:56
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The other issue presently is that the public service at all levels just isn't that attractive as an employer for graduates. I think theres limited opportunity to enculture new grads into the APS or whatever and so what we are seeing is a stack of people who learn the ropes in the Big 4 so culturally it's a missed opportunity. This could also be my biased reading but a lot of government agencies don't really give a poo poo about developing internal capability or holding onto the right people. You can't just parachute that kind of knowledge into a department (thus consultants) and it's a definite shortfall but we are starting to talk some pretty significant and systematic changes and as we all know the APS is definitely the picture of agility and forward-thinking.
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Jan 24, 2023 12:27
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Cartoon posted:When is Farnsey's next farewell tour scheduled? hosed up comment, still too soon
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Jan 26, 2023 07:59
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Megillah Gorilla posted:Speaking of GPs, Labor are promising to overhaul Medicare. Are there any details out at the moment? The forum discussing access to mental healthcare is on Monday but I’m not really optimistic of any real change. There’s been significantly more pressure than I thought though, there has been more of a unified front even across professions which is a good sign.
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Jan 27, 2023 21:06
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Any news about that mental health forum thing held on Monday? This was supposed to be the big thing after the 10 sessions got cut but it’s very radio silence afterwards.
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Jan 31, 2023 00:54
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The only update I've really seen from the Australian Psychological Society came out today and it really seems like a huge wet fart. Mark Butler saying that "oh we'll talk about it on the forum" and then basically have no action come out of it is extremely milquetoast Labor e: below is the text for the APS members, but it's behind a paywall quote:This week, APS members and your patients were represented at the Federal Government’s Mental Health Equity and Access Forum in Canberra to discuss the Better Access review. The APS was well represented, with Dr Zena Burgess CEO and other APS colleagues joining me, alongside several key mental health bodies. lmao
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Feb 1, 2023 10:56
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bobvonunheil posted:Still better than saying "I'll get back to you on that" then following it up with "I talked about that last time" Literally the same answer as before which was "My Budget!!!!" Of course, the irony being that treating mental health at the ED is actually significantly more expensive than sub acute care but it's just classic Labah to throw a pity number at a lived experience group while effectively telling them to eat poo poo by yanking the funding for bare bones MH care.
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Feb 1, 2023 20:56
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Vic Greens in another split shocker
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Feb 6, 2023 04:13
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I need that paracetamol to home brew film developer, don’t gently caress this up for me!!
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Feb 7, 2023 09:18
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I see the ALP are really ramping up the rhetoric against their true ideological opponents, the Greens.
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Feb 9, 2023 23:25
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Labor literally can't help itself but to burn all the goodwill in the electorate to make no-one happy. It's right here in the contract they signed. They could've done something about those stage 3 tax cuts which are wildly unpopular with their own demographic and base but it's just a lot better to wring their hands and shrug about how hard it is. They didn't have to shitcan the additional psych sessions (citing cost) but they just can't afford it despite there being a greater burden of cost when people go acute and have to go to the ED. Same with GP/primary care, we could be funding this but we'd rather fund the system at the point of the hospital. hambeet posted:and they get a little bit terfy at times in some states too. We can just say Victoria
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Feb 15, 2023 21:22
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Breakfast Burrito posted:like if I were an alp stan I would not spend 15 years crying about how we would still be in government and live in a climate utopia but for a comparatively very small political party that apparently had the power to ruin us entirely Not empty quoting
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Feb 15, 2023 23:39
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love to know what the justification for pushing through with those stage 3 tax cuts furiously flipping through the phonebook to find the voter who voted for the ALP on the basis of maintaining those tax cuts lmao
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Feb 16, 2023 10:31
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Can't wait to see how the rusted on ALPers will justify this lmao
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Feb 16, 2023 20:58
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Feb 16, 2023 21:23
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Lmao Fed Labor are pushing 7 billion dollarydoos into the 2032 Brisbane games but we can’t fund additional psych sessions or public housing. Joke political party for clowns, guess they had to build themselves a brand new circus to perform at.
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Feb 17, 2023 05:42
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All that had to do was not knock down that school but here we are The additional 2.7 bill from the state go t could sure build a lot of housing or fund things but I guess we need our Circus Maximus
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Feb 17, 2023 06:01
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