Evaluation of the Better Access initiative component C: analysis of the allied mental health workforce supply and distribution

5.2 Characteristics of the Better Access workforce

Page last updated: September 2010

The Better Access workforce is comprised of allied (psychologists, social workers and OTs) and medical (GPs and psychiatrists) mental health professionals who meet their professional requirements to practice, but may or may not have provided Better Access services.

One of the more difficult aspects of the evaluation was in finding data that could provide the best estimate of the potential Better Access workforce. In the absence of consistent data across the occupational groups, it was necessary to adopt an eclectic approach in which the best data source(s) for each occupation were used in developing estimates of the broader and potential workforces. Table 5.1 summarises the size of the potential and actual Better Access workforce, and in the following sub-sections a brief overview is provided of selected findings for each occupational group in the Better Access mental health workforce.

5.2.1 Psychologists
5.2.2 Mental health social workers
5.2.3 Mental health occupational therapists
5.2.4 General practitioners
5.2.5 Psychiatrists

Table 5.1 Size of the potential and actual Better Access mental health workforce

PsychologistsSocial workersOccupational therapistsGeneral practitionersPsychiatrists
Broader workforce 2006
18,5471
12,4422
9,1601
22,6413
2,8773
Estimated potential workforce 20064
9,088
3,981
6,412
n/a
n/a
Actual workforce 20065
3,688
126
23
12,064
1,086
Actual workforce 2007
6,858
489
115
19,863
1,518
Actual workforce 2008
8,088
646
172
21,324
1,608
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1. For psychologists and occupational therapists the available Registration Board data was used to weight the ABS Census (2006) numbers. These numbers reflect estimates of the number of current, fully qualified practitioners in each profession.
2. For social workers, the ABS Census (2006) data has been used.
3. Numbers of GPs and psychiatrists in the broader workforce were calculated using Medicare Provider data.
4. Estimates used here are based on the number in the broader workforce in each occupation working in the health industry (excluding residential care and social assistance services). These numbers reflect the size of the potential workforce most likely to provide Better Access services.
5. Better Access began in November 2006
Source: Table 2.3, Table 2.6, Table 2.9, Table 2.12, Table 2.15

5.2.1 Psychologists

The size of the potential Better Access psychology workforce varied depending on the reference data source. The ABS Census data was weighted by using information gained from Registration Board data. We estimated that in 2006 there were approximately 18,547 psychologists of whom 49% or 9,088 worked in health care (excluding residential care and social assistance services). Registration Board data indicated that the psychology workforce increased by 10% from 2006-2008.

In 2008, psychologists comprised 90.8% of the Better Access allied mental health workforce. Of the 8,088 psychologists providing Better Access services in 2008, 2,284 clinical psychologists provided Psychological Therapy Services, averaging 343 services per provider; and 6,985 registered psychologists provided Focussed Psychological Strategies, averaging 200 services per provider. These figures equate to the DFTE of 1,308 psychologists (471 clinical and 837 registered psychologists) providing Better Access services.

As a whole the psychology workforce is female dominated (around 75%), with registered psychologists being more likely than clinical psychologists to be located outside of capital cities and major metropolitan areas. The proportion of psychologists over the age of 50 years who provided Better Access services in 2008 was 42%, which was higher than that of the broader psychology population at 34%.

5.2.2 Mental health social workers

The size of the social work workforce was calculated using ABS Census (2006) data. Of the 12,442 social workers identified in the Census of Population and Housing (2006), 32% or 3,981 worked in health care (excluding residential care and social assistance services). The Australian Association of Social Workers provided unpublished data on the numbers of accredited mental health social workers. This rose from 150 in 2006 to 839 in 2008. The use of Better Access by accredited mental health social workers is therefore high, ranging from 84% in 2006 to 75% in 2008.

In 2008, social workers were 6.4% of the Better Access allied mental health workforce. There were 646 social workers providing Focussed Psychological Strategies in 2008, providing an average of 159 services per provider. This equated to a DFTE of 61.2 social workers providing Better Access services across Australia.

Similar to other allied mental health occupations, the social work workforce is female dominated (over 80%). The proportion of social workers over the age of 50 years providing Better Access services in 2008 was 57%, which was higher than that of the broader social work population at 30%. More than 25% of social workers provide services outside of capital cities and major metropolitan centres.

5.2.3 Mental health occupational therapists

The size of the potential Better Access OT workforce varied depending on the reference data source. The ABS Census data was weighted by using information gained from Registration Board data. We estimated that in 2006 there were approximately 9,160 OTs of whom 6,412 worked in health care (excluding residential care and social assistance services).

Occupational therapy is the smallest of the Better Access occupations, being just 1.7% of Better Access allied mental health providers (2008). On average, OTs provided 123 Focussed Psychological Strategy services per provider. This equated to a DFTE of 12.1 occupational therapists providing Better Access services across Australia.

With more than 90% of its workforce being women, the OT workforce is the most female dominated of all the mental health occupations. It also has the youngest age profile with just 12% of the broader OT workforce being over 50 years of age (2006). However, 32% of OTs providing Better Access services was aged over 50 years. Approximately 20% of OTs work outside of capital cities and major metropolitan areas.Top of page

5.2.4 General practitioners

In 2006, there were 22,641 GPs registered with Medicare. General practitioners were 93% of the medical mental health workforce in 2008, providing more than 1.37 million services. Despite the relatively high number of GPs providing Better Access services – 21,324 in 2008 – they did so at relatively low levels. In 2008 GPs averaged 64 services per provider, totalling around 24 hours of client contact, over the whole year. This equated to a DFTE of 303 GPs.

GPs are the most widely distributed occupation across rural and remote areas of all the mental health occupations and GPS in these areas appear to be somewhat more likely than their urban counterparts to provide Better Access services. In contrast to the allied mental health occupations, general practice is male dominated (around 60%). However, GPs providing Better Access services are likely to be older, with 47% being over 50 years of age compared to 39% in the broader GP workforce.

5.2.5 Psychiatrists

Psychiatrists offer specialist mental health services and work with the most difficult and complex psychological disorders. In 2006, there were 2,877 psychiatrists registered with Medicare. By 2008, 1,608 psychiatrists provided over 23,000 Better Access services, equating to a DFTE of 44 psychiatrists. The data indicate that this represented only a very small increase on the previous year.

Despite concerns from the professional bodies that psychiatrists were leaving the public sector, the data did not indicate that there had been a withdrawal of FTE numbers. In contrast, the public sector psychiatry workforce steadily increased since 1995-96 and the trend has barely changed over the past 14 years. There was no indication that Better Access has had a detrimental impact on the numbers in the public sector workforce, however the statistics may mask internal changes such as the level of turnover or the replacement of senior psychiatrists with those more junior.