Queeneth Duduzile Nkosi
Bridget Lee Greenslade
(Mentees of the Student Division Mentorship Programme)
Muhammed Yaeesh Cassim
(Mentorship Sub-Committee Chairperson)
(Mentorship Sub-Committee Vice-Chairperson)
According to the World health organisation (WHO, 2003) as many as 450 million people suffer from mental or behavioural disorders and almost one million people commit suicide each year. In South Africa the health department didn’t consider the study by WHO, when introducing the new scope of practice in September 2011 referred to as the, Regulations Defining the Scope of the Profession of Psychology (GNR 704 in Government Gazette 34581) (“Regulations”).
WHO (2003), in their study, acknowledged that at least one in every four families has a member suffering with a mental disorder.
The laws and regulations in place for those who want to pursue a career in psychology are stringent. These regulations potentially restrict access to mental health care due to scarcity and financial implications of seeking psychological services. This new regulation introduced in 2011 has divisive potential in the psychology community. (https://www.psyssa.com/update-on-replag-vs-hpcsapbp-court-case/)
The Scope of Practice Regulations divided the practice of psychology into nine registration categories. To fully understand the grievances with the new regulations, the nine categories will be briefly defined according to Scope of Practice as printed in the “DEPARTMENT OF HEALTH No. R. 704, 2 September 2011.
- Registered Counsellor: “performing psychological screening, primary mental status screening, basic assessment, and psychological interventions with individuals aiming at enhancing personal functioning; performing psychological assessment excluding projective, neuropsychological and diagnostic tests; enhancing personal functioning; performing supportive, compensatory, and routine psychological interventions; identifying clients requiring more sophisticated or advanced psychological assessment and referring such clients to appropriate professionals (Department of Health, 2011).”
- Psychometrist: “performing assessments, and contributing to the development of psychological tests and procedures; measuring psychological functions including cognitive, interest, aptitude, and personality; identifying clients requiring more sophisticated or advanced psychological assessment and referring such clients to appropriate and registered professionals; providing feedback to clients on the results of psychological assessments (Department of Health, 2011).”
- Clinical Psychologist: “assessing, diagnosing, and intervening in clients dealing with life challenges, particularly those with developmental and forms of psychological distress and/or psychopathology; identifying psychopathology in psychiatric disorders, and psychological conditions; identifying, and diagnosing psychiatric disorders and psychological conditions; applying evidenced-based psychological interventions to people with psychological, and psychiatric conditions; referring clients to appropriate professionals for further assessment or intervention (Department of Health, 2011).”
- Counselling Psychologist: “Assessing, diagnosing, and intervening in clients dealing with life challenges, and developmental problems to optimise psychological wellbeing; assessing cognitive, personality, emotional and neuropsychological functions in relation to life challenges and developmental problems; assessing developmental processes (e.g. career choice), and adjustment (Department of Health, 2011).”
- Educational Psychologist: “assessing, diagnosing, and intervening to optimise human functioning in the learning and development; assessing cognitive, personality, emotional, and neuropsychological functions of people in relation to the learning and development in which they have been trained (Department of Health, 2011).”
- Research Psychologist: “planning, developing, and applying psychological research methods; performing assessments relevant to the development of research for research purposes, including the development of psychological measures; researching, monitoring, and evaluating psychological interventions (Department of Health, 2011).”
- Industrial Psychologist: ”planning, developing, and applying paradigms, theories, models, constructs, and principles of psychology in the workplace to understand, modify, and enhance individual, group, and organisational behaviour effectively (Department of Health, 2011).”
- Neuro-psychologist: “assessing, diagnosing, and intervening in the psychological disorders of people experiencing neuropathology or compromised functioning of the central nervous system; diagnosing, and evaluating psychological disorders caused by neurological conditions and differentiating them from other psychological and non-neurological disorders; treating, and rehabilitating the psychological disorders of people suffering from central nervous system dysfunction; referring clients to appropriate professionals for further assessment on intervention (Department of Health, 2011).”
- Forensic Psychologist: “conducting psychological assessments, diagnoses, and interventions, referring clients to appropriate professionals for further assessment or intervention; providing therapeutic interventions; advising on the development of policies, based on forensic psychological theory and research (Department of Health, 2011).”
In February 2017, PsySSA held a meeting where new models were proposed to address the court’s ruling. Many psychological organisations, professionals and students attended this meeting and provided their input. At the end of the meeting, seven models were proposed for consideration (PsySSA, 2017). However, these models are only proposals, and remain independent from and are not endorsed by the HPCSA and the Board of Psychology (PsySSA Office, 2017).
Careful considerations should be given on how such changes will influence current professionals and students. The new model should have relevance in line with the needs of the South African population. It should contemplate the role of the medical aid schemes and whether or not they should pay for psychological services. It should also reinforce the authority of the Health Professions Council of South Africa and the Board of Psychology.
The remodeling of the scope saw educational psychologist like Gerhard van Niekerk’s clientele drop from 240 sessions a month to 40 sessions. (businesslive.co.za). The regulations drawn in 2011 saw the narrowing of the scope of practice, depriving some who have passion for helping those suffering from mental health conditions, the right to render their services.
Students who are trying to endeavor on a journey of becoming psychologist are left confused on which path to take due to these changes. But how can one strive to reach their goal against all odds set out by the health department, only to suffer after qualifying?
As Cora Smith stated, the chief clinical psychologist at Charlotte Maxege Johannesburg academic hospital, when delivering her statement on the 2011 regulation she noted that, “in South Africa we have a moral obligation to provide psychological services to all South African citizens in need. As matters stand we do not meet the minimum requirement of 5 psychologists per 1000 000 in a developing country.
To conclude in Smith’s words “it is essential that we do not turn on each other but stand together”. Various role players have come together to address the issue of the relevance of the scope of practice. The solution can only be found when all parities work together to construct a way forward for the Profession of Psychology. We at PsySSA Student Division wish them well in this endeavor.
Department of Health. (2006, August 4). Ethical Rules of Conduct for Practitioners Under the Health Professions Act, 1974. Government Gazette (No. 29079), pp. 15-47.
Investing in mental health. (2003). Retrieved from https//:www.who.int/mental-health/media/investing_mnh.pdf. Accessed on the 17 August 2017
Difficulties billing the medical aids using the billing system. (2017, February 7). Retrieved from https//:www.businesslive.co.za/bd/national/health/2017-02-07-categories-of-psychologists-hit-as-payments-dry-up/. Accessed on the 17 August 2017