Registered counsellors are key to building a viable and sustainable mental healthcare system in South Africa. Despite this, much of the potential of these foot soldiers remains unrecognised and therefore underutilised. Effectively, side-lining invaluable resources that are desperately needed to provide adequate mental health care services and counselling across South Africa.
Why is this happening? Dr Laura Fisher is the Director of Academic Affairs at the South African College of Applied Psychology (SACAP). Her PHD, Registered Counsellors at a Crossroads¸ provides great insight into the current situation and its challenges. We asked her to unpack some of the realities faced by Registered Counsellors in South Africa. This is what she shared:
5 Insights into the Registered Counsellors being an Underutilised South African Resource
1. Categorisation
It is argued that the current Scope of Practice, as set by the Health Professional Council of South Africa HPCSA, is prejudiced against registered counsellors. What do you think?
The current scope of practice falls short of highlighting the potential of the registered counsellor’s category within the psychology profession. Practically, registered counsellors are most often seen relative to clinical psychologists. Thereby, limiting their scope of practice to a clinical/medical psychology discourse of abnormality-, dysfunction- and individually-oriented treatments. However, the registered counsellor’s category was actually envisioned to create groundswell for scaling up National delivery of and access to mental healthcare services. Thus, registered counsellor services are intended to differ from others within psychology. This is because they should, ideally, be focused on providing psychological interventions aimed at prevention and mental health promotion and wellness.
“There is a gap between policy frameworks and practical rollout services.”
2. Roles
If the current status quo was changed, what role could registered counsellors play in alleviating the demand on South African public mental health services?
A registered counsellor is well positioned to provide community-based psychological interventions. For example, they could provide supportive counselling services, promotion of mental health and wellbeing, psychological screening and assessment or psychoeducation. Registered counsellors could, and should, also play a role in bridging policy intention with actual rollout. Such as those proposed by the National Mental Health Policy Framework and Strategic Plan 2013-2020 (Dept of Health, 2013) to enhance accessibility to mental healthcare.
3. Obstacles
What is one of the primary obstacles to entry in community settings for those within the mental health profession?
The heart of our current policies is increased access to mental healthcare and supportive counselling services at a community-based level. However, South African employment trends serve as a significant barrier. Specifically for those professionals who want to meaningfully address the plethora of our country’s mental health challenges. Thus, while a registered counsellor’s category theoretically positions them to make a meaningful contribution, gainful employment to practically do this is problematic.
4. Focus
Rather than being treatment focused, is there a vital need for professionals to be part of preventative community-based care services? If so, what is stopping this shift in primary attention from happening?
Professionals should absolutely be part of community-based care services that actively engage in preventative work. There are many mental healthcare workers that long to serve under-resourced and disadvantaged communities. They are passionate about closing accessibility gaps in relation to community experiences of adequate counselling and community based psychological interventions. What is stopping this from happening? Basically, it’s because the greatest needs have the least resources allocated to addressing them. This results in needs being identifiable but an inability to adequately pay for the required services. Practically, professionals are then put in a very difficult position. They must offer their services on a voluntary basis. Or alternatively, earn suboptimal salaries and supplement their income with private practice. Neither of which are ideal or sustainable.
“Registered Counsellors are key to preventative service provision.”
5. Solutions
What would you propose that could address these problems?
If all mental health professionals had mandatory community service, then the deficit in human resources within psychology would be decreased. However, for a sustainable and longer-term solution, it is critical that the psychology profession engage with the government. Specifically, to create employment opportunities for registered counsellors. The continual lack of jobs within the Departments of Health, Education, Correctional Services, Social and Youth Development need to be addressed. If these jobs were available, there would be tremendous upliftment benefits for communities across South Africa.
Mental Healthcare Study Opportunities
SACAP is a leading provider of social work and community development, counselling, coaching and psychology courses. Courses equip students with both theoretical and practical skills. This puts our graduates in a great position to be able to make a positive impact when they start working. Contact one of our student advisors for more information or enrol online today.
