Discussions about psychology workforce shortages often focus on one solution: training more psychologists. The PsyBA proposal is the latest example. Yet the greatest gaps in access to psychological care remain concentrated in rural, remote and lower socioeconomic communities. While Better Access has expanded access to psychology for many Australians, there are communities where attracting and retaining psychologists remains difficult regardless of demand. My experience working in a remote mental health service taught me that producing more psychologists and improving access to psychologists are not necessarily the same thing.
Producing more psychologists may help, but it doesn't address the bigger question: why do psychologists struggle to move to, and stay in, these communities?
I think about this sometimes because, once upon a time, I was a provisional psychologist working in a remote mental health service over 2,000 kilometres from the city.
How did I end up 2000kms away from home?
What attracted me there?
It wasn't a job.
It wasn't the money.
It wasn't the adventure or the open spaces.
It wasn't even the opportunity to gain experience.
It was love.
I met the love of my life while he was working in a remote town. After a year of long-distance dating, I decided to move across the state to give the relationship a chance. I couldn't even find a position in the same town, so I ended up taking a role in a community two hours' drive away on a remote road that, at the time, didn't even have phone coverage.
All of my friends thought I was crazy.
What helped moving for love possible?
What made that move possible was the support that came with the role:
• Housing support
• Air-conditioning subsidy
• Relocation assistance both ways
• Annual travel allowance
That position turned out to be an incredible learning opportunity. It helped prepare me for a Master of Clinical Psychology and ultimately a career as a Clinical Psychologist.
But even with all of that support, and even with a very strong personal reason for being there, it was hard.
I stayed for two years.
As it happened, two years was about as long as many people stayed in the region, including those who had moved there for reasons other than love.
It’s not just about filling a vacancy.
The reality is that transplanting yourself into a rural or remote community isn't easy. It's not simply about filling a vacancy.
There are often limited opportunities for career progression. My partner and I could have stayed indefinitely, but doing so would likely have meant remaining at the same level for the rest of our careers. For many professionals, leaving isn't about dissatisfaction with the community. It's about building a future.
Then there are the practical considerations: finding suitable employment for both members of a couple, access to childcare, schooling options for children, professional development opportunities, and the simple reality of being a long way from family and support networks.
Will producing more psychologists solve this problem?
Maybe it will help fill some additional government-funded positions if competition for metropolitan jobs increases. Perhaps more psychologists will spend time in rural and remote communities while building experience. Maybe some will stay.
But increasing workforce numbers alone does not address the barriers that make recruitment and retention so difficult in the first place.
It's even less likely to improve access to private psychological services under current funding models.
Government positions often come with relocation assistance, housing support and other incentives. Private practice generally does not. At the same time, many rural and lower socioeconomic communities have fewer residents who can afford ongoing out-of-pocket fees. The result is that establishing a financially viable private practice can be extremely difficult.
I've supervised psychologists who desperately wanted to return to their home communities and provide care there. They simply couldn't make the financial realities work.
The answer isn't just producing more psychologists.
Perhaps it's recognising that workforce shortages in rural and remote Australia are primarily a recruitment and retention problem, not simply a training problem.
Maybe it's acknowledging that Better Access doesn't work equally well in every community.
And perhaps it's accepting that if we genuinely want better access to psychological care in underserved regions, we need to invest much more heavily in attracting people there, supporting them while they're there, and creating reasons for them to stay.
But creating more psychologists through a Bachelor degree program is not the answer.
Nadene van der LInden is a Clinical Psychologist, EMDRAA Accredited EMDR Consultant & Therapist, ISST Certified Advanced Therapist and Supervisor in Schema Therapy and Psychology Board Approved Supervisor.
