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The Hon Paul Fletcher MP, The Hon Sarah Henderson MP, Ms Renee Leon PSM: INCREASE ACCESS and FAIRNESS to MENTAL HEALTH ASSESSMENT

The Hon Paul Fletcher MP, The Hon Sarah Henderson MP, Ms Renee Leon PSM: INCREASE ACCESS and FAIRNESS to MENTAL HEALTH ASSESSMENT

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The Hon Paul Fletcher MP, The Hon Sarah Henderson MP, Ms Renee Leon PSM
Our most vulnerable and highest need citizens are having their mental health assessments declined!

In January of 2012, the new impairment tables for determining an individual’s capacity to work were implemented. A number of bodies were consulted for the review and the Australian Psychological Society were part of the consultation. Upon considering the impairment table No.5 - Mental Health Function, the argument put forward was that

     “...a high level of diagnostic expertise is required, given the diagnosis of a mental health condition can be challenging, and therefore must be made by an appropriately qualified medical practitioner, including a psychiatrist. The committee was of the view that if the diagnosis had not been made by a psychiatrist, then the diagnosis must be supported by evidence from a clinical (endorsed) psychologist”.
Kath Payton
A/g Branch Manager
Families and Pensions
29th May 2018

Table No.7 - Brain Function, states 

Table 7 is used to assess functional impairment related to neurological or cognitive function.
The diagnosis of the condition must be made by an appropriately qualified medical practitioner. This includes a general practitioner or medical specialists such as a neurologist, rehabilitation physician, cognitive neuroscientist, psychiatrist or neuropsychologist.
People with an autism spectrum disorder or foetal alcohol syndrome or foetal alcohol spectrum disorder who do not have a low intelligence quotient (IQ) should be assessed using Table 7.

All registered psychologists are currently permitted to practice across all areas of psychology and mental health and can diagnose, assess and treat clients, regardless of whether they are endorsed or not. Ethical guidelines require psychologists to only provide services within their limits of personal competence. Many generally registered psychologists are highly trained in assessing, diagnosing and treating cognitive and neurological conditions such as brain injury, developmental delays and Autism Spectrum Syndrome. 

To date, there is no evidence to support that endorsed psychologists are better trained or superior in their treatment, assessment and diagnosis of mental health conditions. The Australian Clinical Psychology Association state that “More than half of those clinical psychologists endorsed by the Psychology Board of Australia, do not have qualifications in clinical psychology....” (source:
This means that many generally registered (non endorsed) psychologists hold the same level of training as endorsed psychologists.

Many psychologists have worked as Job Capacity Assessors and have had their recommendations for an individual’s mental health capacity accepted by Centrelink in the past. In addition to their assessment and diagnostic training, these non endorsed psychologists as Job Capacity Assessors, worked within the JCA/ESAt (Employment Services Assessment) policies that included:
Identification of Barriers and Interventions
- Determine Work Capacity for a fully diagnosed, treated and stabilised medical condition
- For Disability Support Pension (DSP) portability review assessments, determine both functional impairment and work capacity over a five year view.
- Determine whether the customer has actively participated in a program of support
- Assessment of Continuing Inability to Work (CITW)
-The best available medical evidence:
- Sources of medical evidence
- Other medical evidence
- Non-medical evidence

Many of the above policies are integral to psychological reporting regardless of the report purpose and are considered to be part of best practise. 
Despite the above, generally registered psychologists are now not considered skilled or experienced enough to diagnose and assess impairment and capacity.

This means that an individual who has been seeing a non endorsed psychologist is required to seek out a clinically endorsed psychologist to write a report for Centrelink. This is an extremely stressful, costly and time consuming endeavour for people who are struggling with a mental health condition and unnecessary when their current treating psychologist has a wealth of information and knowledge about their condition.

The following is an account from a psychologist and their client’s experience of applying for a DSP under the current impairment table guidelines:

“I had Bulk-Billed a client for 10 Psychology sessions under Medicare. She asked me if I could help her complete a Disability Support Pension Application Form for her. No problem, I thought, because I had actually even worked in a real paid job as a Job Capacity Assessor at Mission Australia doing outsourced Centrelink Work during my 4 + 2 Internship, and have worked at the coalface full-time for almost a decade, in one of the most diverse LGA’s Socio/Economically in Sydney.

The client was told by Centrelink Staff that my assessment report was not valid because it had to be done by a “Clinical” Psychologist or Psychiatrist, despite the fact that I had worked as a Job Capacity Assessor and my reports were acceptable then.

I trained and did real work in a Clinical setting from Day 1 after leaving University.I learned more post-University because I was trained daily doing real work under a real psychologist with real clients – not mostly career academic University Staff with no teaching qualifications and seemingly little experience working as Sole Traders in private practice, doing imaginary role plays and writing copy and paste reports ad nauseam.Working in private practice is a hell of a lot different to working in relatively sheltered academic and government related postings.

I believe academics should at least be required to have Qualifications in Teaching and at least 5 years full-time work as a sole trader in a private practice.One of us “Generalist’s” harshest critics, appears to fit the above criteria to a tee, given their online resume.I pass the Pub and Duck Test and I believe, like others, I should be able to call myself a Clinical Psychologist, because that is what I do and what the public see that I do. We are really just talking semantics here with that “protected” term Clinical.

Anyway, the client could not afford to pay for further sessions with a “Clinical” Psychologist or Psychiatrist, so she was very distressed. We had built up a solid rapport over time and she just could not understand why Centrelink would not accept my report. She understandably questioned my Registration to Practice as a Psychologist and I felt my integrity and professionalism was being undermined by Centrelink;  and felt I should not have had to try and justify myself.

The client was very upset with all the inconvenience and had to go back to Centrelink to explain that she had used up her full quota of 10 sessions.Centrelink then referred her to a “student” psychologist in training at the Psychology Clinic at U.W.S.Centrelink accepted that student report over mine! I was so outraged I asked her if I could have her written permission to disclose this situation to whoever/whenever; and she agreed”.