The House of Representatives yesterday started to debate a bill to formally establish and regulate the profession of psychology in Malta.
Social Affairs Minister Dolores Cristina said the psychology profession was growing fast, hence the need for this bill. Malta also needed to align itself with EU requirements.
The bill was the result of wide ranging consultations with all concerned, although not all suggestions were taken up by the government.
The bill established the minimum requirements necessary for one to obtain a warrant to practice the profession and included provisions to protect service users.
Ms Cristina said no one would be able to hold himself out to be a psychologist or exercise the profession of psychology without a warrant issued by the minister on the advice of the Malta Psychology Profession Board.
Among other requirements, the applicant for a warrant must be in possession of a Masters degree in psychology and must satisfy the board that he/she has received adequate experience in the practice of the profession of psychology for an aggregate period of at least two years.
The bill defines psychology as being "the professional service that is performed for the purpose of the diagnosing, preventing, remedying or ameliorating human mental, emotional, behavioural or relationship difficulties, in order to evaluate or enhance human performance and to enhance mental or physical health."
One had to make a distinction between two professions: psychology and psychiatry, the latter dealing more with the medical aspect.
Ms Cristina said the Malta Psychology Profession Board would be composed of seven members. Four would be appointed by the minister responsible for social policy including a chairperson with six years' practice in the profession, two psychologists, one of them in the public sector and a lawyer with five years' experience. Another two members would be nominated by associations registered with the board. The other member would be nominated from the permanent academic staff responsible for psychology education and training at the university.
The main role of the board would be to regulate the practice and the eligibility to practice the profession of psychology in Malta. That role included establishing and, where necessary, assessing psychology standards as well as examining applications for warrants. The board would also make recommendations to the minister on a code of ethics, inquire into allegations of professional misconduct or incompetence.
The board could also recommend to the minister that a warrant may be suspended or cancelled, in which case the warrant holder may file an appeal in the courts.
Opposition spokesman Karl Chircop said the opposition would vote in favour of this bill but was critical of the fact that it had taken the government so long to move it before parliament.
There was no doubt that the demand for services by psychologists was rising. Indeed, the waiting list for the service of psychologists at the Child Guidance Unit of St Luke's was far too long, with no appointment currently possible before the second half of July. Action needed to be taken to improve this situation, which stemmed from an acute shortage of psychologists.
Dr Chircop referred to specialisations, which may enable an applicant to be granted a warrant, and said such specialisations should be defined so as to prevent the possibility of abuse.
Would psychologists practising in the EU have an automatic right for a warrant in Malta?
Dr Chircop said one of the most important steps the government could take to further the profession was to ensure that the Mastersdegree was opened more frequently at the university.
Indeed, this law should be followed up with other practical actions. For example, the Employment Training Corporation should engage a psychologist, given the psychological problems which unemployment sometimes caused. But such employment should, at least, carry the same remuneration as that in the Education Department. He was informed that the terms currently offered by the ETC were inferior.
Quoting the definition of psychology given in the proposed law, Dr Chircop focused on the word 'diagnosis' which should be the duty of the psychologist and not of the general practitioner. There was no reference to the 'cure' to be given to the patient. The psychologists had no authority to prescribe medicine but he/she may propose treatment for a particular behaviour or condition. The duty of prescribing medicine lay with the psychiatrist.
On the composition of the board, Dr Chircop asked why there no post of registrar. Furthermore, he questioned what would be the procedure for filing a compliant?
Making his maiden speech Dr Joseph Cassar (PN), himself a psychiatrist, said the absence of a proper distinction between psychologists and psychotherapists was possibly the biggest problem Malta was facing in the sector. The Bachelor's course was only an introduction for psychotherapists, but did not make graduates psychologists. This could have serious effects on patients who were not in a position to make the distinction.
Clinical psychologists' patients usually had very serious problems, sometimes even bordering on the life-threatening, and the country needed to be very careful in who could and should have the necessary warrants to do such work.
If the bill regulated psychologists but not psychotherapists, the system would be seriously imbalanced.
Dr Cassar also called for the reopening of the Masters course at the university. Bachelor graduates who opted not to go further could still find related work to do, such as assistant psychologists under the supervision of a registered psychologist.
There were several important sub-sections to psychology, all of which catered for different problems and situations. Each of the sub-sections should be defined in the bill to make it more meaningful.
Psychometric and personality tests should be handled only by qualified psychologists because they required acute observation besides the answering of questions. The real problem behind the long waiting lists of schoolchildren lay in the lack of psychologists. Good service could not be given in this line unless more psychologists qualified.
The situation was exacerbated by certain schools' inability to distinguish between educational and clinical psychology. Better communication could help to alleviate the problem.
Mr Evarist Bartolo (MLP) said that as in other professions, the need for psychologists in Malta was on the rise.
Malta was still very far from the internationally accepted ratio of a psychologist for every 7,000 schoolchildren. Locally two educational psychologists were expected to cater for the needs of 70,000, leading to years-long waiting lists and some practitioners deciding not to even refer the children.
Unless this situation was meaningfully redressed, all the educational policies and systems drawn up would go to ruin.
Mr Bartolo expressed disappointment at the fact that the government had taken no steps to reopen the Masters course at university over the past four years.
The Lm20,000 needed to run M.Psych. courses should be found - that amount was equivalent to less than two overseas trips by the prime minister using private aircraft.
There was also need for student psychologists to carry out their training in the same Maltese society that they would eventually serve.
The current shortage of psychologists, even in the private sector, was such that quality of service sometimes deteriorated. For example, parents were often given a standard report on their children, and charged Lm40, when they sought an assessment in order to apply for the service of a facilitator.
Mr Bartolo quoted the Malta Psychologists Association's concerns that the bill, which set the Masters degree as a minimum, made no reference to B.Psych. graduates in spite of the difficulties of the course.
He also asked how oversees degrees would be recognised.