The shortage of doctors in rural Australia is dire, but it’s by no means an outlier across the health professions.
Children living rurally deserve better than what they’re getting.
Professor Saravana Kumar made some excellent points in The Medical Republic’s recent article about the need to deliver child-centred, place-based care that’s co-designed with local communities.
From the perspective of a peak professional body, the Australian Association of Psychologists, we believe the Australian government could work more closely with psychologists to better ensure that the mental health needs of children in regional and rural areas are met through a coordinated, multi-pronged approach.
This could include initiatives like:
- strengthening the workforce availability in regional areas
- incentivised relocation for psychologists to live and work in regional and rural communities
- training pipelines where universities partner with local service providers to create rural placement programs and regionally-based postgraduate pathways, encouraging early career psychologists to train and remain in local areas
- providing ongoing supervision and professional development to local professionals to reduce professional isolation and burnout among rural clinicians
- increasing the Medicare rebate for psychologists working in regional, rural and remote areas
- abolishing the two-tiered Medicare rebate system for psychologists, which would create greater equity for those who choose to work in these areas.
Access to face-to-face services could be improved by mobile clinics and hub-and-spoke models, which may provide continuity of care by enabling psychologists to visit communities on a scheduled basis and allowing them to rotate between locations.
The limitations of telehealth need to be addressed by improving digital infrastructure to ensure stable internet access in underserved areas, including government subsidies for satellite or mobile-based internet services.
The creation of private telehealth spaces in schools, community centres or libraries where children (and their families) can attend sessions if the home internet is unreliable or unavailable would increase access.
It is essential to acknowledge that while telehealth services increase accessibility to services, it cannot replace all in-person services, particularly for younger children or those with complex needs.
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Economic barriers to access should be addressed through fully funded services by increasing investment in free or low-cost mental health services in rural and regional areas, particularly those tailored to children and adolescents.
Medicare-funded sessions should be expanded to provide increased block-funded community mental health programs so that families are not left with significant out-of-pocket expenses, and there needs to be adequate funding for psychological assessments and interventions that cannot be accessed via telehealth.
Alongside this somewhat hefty wish list, it is essential to foster culturally safe, community-led care via community collaboration. This should include engaging local communities – including First Nations groups – in designing services that are culturally safe, relevant and trusted, and encouraging collaboration between psychologists, general practitioners, educators, youth workers and others to provide wraparound care in settings where specialists are scarce.
When data around regional child mental health care needs and service utilisation is considered, it should inform targeted investment and lead to stakeholder consultation, maintaining ongoing dialogue between governments, peak psychology bodies, rural health alliances and education sectors to ensure responsive policymaking.
Daniela McCann is the director of the Australian Association of Psychologists (AAPi).
