Accreditation proposal for psychologists could leave English-speaking patients without help and force professionals out of work

A proposal to set criteria for accrediting clinical psychologists favours local graduates and could put foreign-trained professionals at a disadvantage, even shrinking the city’s English-language services leaving patients high and dry, say critics.

Hong Kong’s clinical psychologists are vastly divided on how the city’s accreditation system should work. Approving the controversial proposal could affect service to patients and the career prospects for psychologists trained outside of Hong Kong. Such psychologists make up one-sixth of the city’s practitioners.

There are concerns that forcing them out of the trade could leave English-speakers with nowhere to turn for help and raise prices dramatically. This could impact particularly harshly on low-income, non-Cantonese speaking patients.

Closing the door or upholding standards

Currently, Hong Kong does not require clinical psychologists to be licensed or registered with a government agency or professional board to practise in the territory so as to ensure “professional autonomy”.

But, to better uphold healthcare standards, Hong Kong’s health ministry has rolled out the Accredited Registers Scheme for Healthcare Professions, which operates under the principle of “one profession, one professional body, one register”.

Simply put, one professional body will be accredited and responsible for administering the register of its profession. Entering the register means clinical psychologists are accredited, which could help reassure patients and increase chances of getting hired to serve more patients.

Protecting their own

But this push has given way to disputes since the Hong Kong Psychological Society’s Division of Clinical Psychology (DCP), a major body in the profession mainly made up of clinical psychology graduates from Chinese University (CUHK) or Hong Kong University (HKU), proposed criteria for accreditation that may favour locally trained practitioners.

“The proposal provides for an unobstructed registry for clinical psychology graduates from CUHK and HKU, while those graduated or licensed elsewhere will have to meet certain requirements even if they hold a doctoral degree. This is unfair,” says Dr Joseph Siu, chairman of the Hong Kong Association of Doctors in Clinical Psychology (HKADCP), another major professional group.

“To be eligible for accreditation, these clinical psychologists will need to go through remedial training, which will take 300 hours and require an annual review by a supervisor and an employer. This is insulting for already-experienced clinical psychologists,” he adds.

DCP’s proposal requires applicants to have professional knowledge and skills in local psychological testing – hence the need for remedial training in Hong Kong.

Few foreign trained clinical psychologists would have worked in local settings due to the location of the training programs as well as cultural and linguistic differences.

Dr Siu explains that the remedial training will create an added burden for overseas-trained clinical psychologists and this will affect their work and their prospects for employment.

Proposed requirements violate ethical codes

Another criterion that Dr Siu finds absurd is the proposed admission review to assess applicants on a case-by-case basis. They will have to submit proof of their practice experience, which will involve handing over patient records. This is not only technically difficult, as it requires patients’ consent, but also against ethic codes.

Despite the criticism, DCP’s proposal has been given a priority review as the group represents more clinical psychologists in the city than any other.

“We are trying to extend clinical psychological service to more communities. If there are fewer psychologists on the market, the public will have limited access to mental health service and rely more on the public healthcare sector, which will result in longer waiting time to get treated,” Dr Siu explains.

He adds that many of the clinical psychologists trained overseas are working at NGOs to serve the mentally vulnerable groups.

Impact on the vulnerable

Setting the bar higher for overseas trained psychologists, who may not be Cantonese speakers, could also have an impact on the local non-Chinese speaking community, warns Ms Shalini Mahtani, the founder of the Zubin Foundation.

“Our ethnic minority community represents 3 percent of Hong Kong’s population. If the mental health provider is not able to fully understand what you are saying because of the subtleties of the language, that is a problem, and a risk to the patient. This is simply unacceptable,” she explains.

“Some of the youth in the ethnic minority community have given examples of how their local practitioner has just not understood the cultural sensitivities of their culture. We have had to refer them to the overseas practitioners in Hong Kong, some of whom have had much more exposure to the South Asian and South Asian communities,” Ms Mahtani adds.