Submission to Senate Inquiry on mental health of ADF personnel

The Psychotherapy and Counselling Federation of Australia (PACFA) welcomes the Senate Inquiry on the mental health of Australian Defence Force (ADF) personnel. With the prevalence of mental illness among returned service personnel being significantly higher than in the general population, the inquiry is important to identify shortcomings in the service system which may be impacting on outcomes for returned service personnel, and to address the growing mental health needs of this client group. PACFA calls on the Inquiry to identify specific recommendations to improve the effectiveness of mental health care for returned service personnel and their families and to promote their mental health and wellbeing through the provision of counselling and psychotherapy services.

Counselling and psychotherapy are interdisciplinary activities provided by a range of professionals, including counsellors and psychotherapists, as well as psychologists, social workers, occupational therapists, nurses, doctors and psychiatrists. Counselling and psychotherapy are not ‘owned’ by any one of these professional groups. It is therefore surprising that counsellors and psychotherapists have long been overlooked as part of the Department of Veterans Affairs’ (DVA) mental health workforce. With the introduction of a statutory registration system for DVA mental health providers, the workforce has been limited to practitioners with Medicare provider numbers. The Veterans and Veterans’ Families Counselling Service (VVFCS) has also limited its workforce of outreach counsellors to psychologists and mental health accredited social workers (VVFCS, 2015). Furthermore, PACFA is not aware of any PACFA-registered counsellors or psychotherapists being employed by the VVFCS as staff counsellors. In PACFA’s view there is no valid rationale for these workforce restrictions.
Counsellors and psychotherapists are highly trained and skilled, and those registered with PACFA as Mental Health Practitioners are recognised as meeting key mental health competencies.

Access to counselling and psychotherapy for returned service personnel and affected family members is essential for effective service outcomes, particularly as an early intervention strategy; to promote mental health and well-being; and as a treatment option for clients requiring more intensive clinical treatment. There is an abundance of evidence for the effectiveness of counselling and psychotherapy. This evidence holds true when these interventions are delivered by qualified counsellors and psychotherapists. There are also specialist therapies such as family therapy, relationship counselling, art therapy and body-focussed psychotherapy that should be delivered by specialist practitioners in
these fields, such as specialist PACFA-registered counsellors and psychotherapists. Additionally, counsellors and psychotherapists are more widely available in rural and regional Australia than psychologists.

Recommendations to the Senate Inquiry and the DVA:

1. Include registered counsellors and psychotherapists in the workforce of the VVFCS to broaden VVFCS clients’ choices about the practitioners, models, skills and interventions available to them.
2. Develop DVA’s purchasing guidelines to enable registered counsellors and psychotherapists, who are skilled and qualified to provide evidence-based interventions, to become DVA providers.
3. Support the extension of Medicare provider numbers to registered counsellors and psychotherapists to enable DVA to use them as providers. This will improve client choice, better match practitioners and interventions with client needs and preferences, and address workforce shortages in rural and regional Australia.
4. Offer specialist interventions, provided by suitably trained practitioners, such as art therapy, body-focussed psychotherapy, family therapy and relationship counselling, to returned service personnel and their families.
5. Increase access to VVFCS programs to strengthen the capacity of spouses, partners, carers and family members to support returned service personnel with help seeking behaviours, healthy lifestyles and recovery.
6. Consult with PACFA, which has research expertise, to help build the evidence base for counselling and psychotherapy as elements of effective mental health care.

Download PACFA’s submission to Senate Inquiry