Psychologists in Physical Health Services in New Zealand
Stewart, Malcolm W., New Zealand Journal of Psychology
Explored utilisation of psychologists in physical health services in New Zealand. Psychology Advisors and Professional Leaders in District Health Boards (DHBs) were surveyed about the DHB psychologist workforce, particularly in physical health. Seventeen percent of DHB psychologists worked in physical health services. Psychologist positions in physical health had increased 82% in the last five years--three times the increase in mental health psychologist positions. The DHBs varied widely in utilisation of psychologists in physical health. Most psychologists in physical health were Clinical Psychologists. Positions for health psychology interns are increasing, suggesting growing acceptance. Results suggest rapid growth of psychologist roles in physical health services in New Zealand. This may reflect greater recognition of the importance of managing psychological and social factors in treating physical disorders, and how psychologists can help improve effectiveness and outcomes in physical health services.
Psychologists potentially have a strong role within physical health services in New Zealand (Rozensky, 1994; Stewart & Young, 2007). Many of the major causes of mortality and morbidity in developed countries are conditions for which modifiable health behaviours and lifestyle factors are significant either as risk or protective factors (World Health Organisation, 2005). For these physical disorders, psychological and behavioural factors may contribute substantially to the condition and the resultant impairment, disability, and handicap (Royal College of Physicians and the Royal College of Psychiatrists, 1995). Many people who present to physical health services have significant psychological needs that may be causal or maintaining of their disorder, or arise from the development of their disorder (Peveler, Kilkenny, & Kinmoth, 1997). There is increasing evidence that psychologists and psychological techniques can play a significant role in assisting the enhancement of physical health (see Marks, Murray, Evans, Willig, Woodall, & Sykes, 2005, for an overview). There is also evidence that psychological input can improve outcomes for people with a range of physical health difficulties and can lead to service cost savings (e.g. Anderson, 2002; Chiles, Lambert, & Hatch, 1999).
While psychologists in New Zealand have been interested and involved in working with people with physical health difficulties since at least the 1970s (Carlson, Smith, & Sheppard, 1993; McKerracher & Walker, 1982) utilisation of psychologists within physical health services has remained relatively inconsistent and limited (Stewart, 2001). In recent years Health Psychologists with clinical competencies have begun to be trained in New Zealand. There has in the last decade been a growing interest and commitment within the New Zealand physical health services towards the involvement of psychologists (Stewart, 2001).
This paper reports the results of a survey of the role that psychologists are playing in physical health services within the New Zealand publicly-funded health system. In particular, the paper explores the size of the workforce of psychologists in physical health, the types of physical health services that are employing psychologists, and the growth in the utilisation of psychologists in physical health services over time.
Participants in this study were the Professional Leaders for Psychology (or Psychology Advisors) for the 16 of the 21 District Health Boards (DHBs) in New Zealand. Professional Leaders for Psychology (or their equivalent), were identified for eighteen of the twenty-one DHBs in New Zealand. Sixteen Professional Leaders (representing 89% of the 18 DHBs with identified Professional Leaders, or 76% of all the DHBs in New Zealand) responded to the questionnaire that forms the basis of this study. Of the remaining three DHBs, two did not employ psychologists at the time of the study and no response was received from enquiries with the third. …