Health department endorses that psychologists without a specialty treat patients in Primary Care

PalmaThe Department of Health defends the incorporation of general health psychologists into the public Primary Care network to respond to the increase in the demand for mental health care. The Director General of Mental Health, Carme Bosch, considers that these professionals have sufficient training to take on cases corresponding to the first level of care, while psychologists specializing in Clinical Psychology must attend to disorders of greater complexity. The Official College of Psychology of the Balearic Islands (COPIB) also endorses the incorporation of general health psychologists and demands, at the same time, an increase in PIR training places, because it considers the two paths to be compatible. Clinical psychologists, on the other hand, have expressed their discomfort to the Department regarding the incorporation of this profile into the public health system.

"They are different professionals," argues Bosch. According to the general director, general health psychologists "have more than enough competencies to handle the first level of health management, as they perform similar interventions in the private sector." On the other hand, psychologists specializing in Clinical Psychology are the professionals trained to address the most complex mental disorders. "In these cases, only they are there," she adds.

The main difference between the two profiles is the training. To practice as a general health psychologist, it is necessary to have a degree or bachelor's degree in Psychology and a master's degree in General Health Psychology. Clinical psychologists, on the other hand, obtain their specialization through the specialized health training system, the PIR, which involves four years of residency.

Lack of PIR places

The shortage of clinical psychologists is not new. Last September, Bosch herself explained to ARA Balears that the lack of specialists in the Balearic public health system was a problem shared with the rest of the State and linked it, in part, to the scarcity of Resident Intern Psychologist positions announced by the Ministry of Health. At that time, Bosch pointed out that the regulations required specialized care positions to be filled by clinical psychologists and suggested two ways to expand coverage: increasing PIR positions or finding formulas to reinforce care.

Now, the Health Department has opted to incorporate general health psychologists into Primary Care. The idea is for these professionals to take on less complex cases and refer patients who need specific intervention to specialized services. Patients treated in Primary Care usually have between three and five sessions. If there is no improvement, the number can be increased to eight and, if the patient continues not to respond to treatment, they are referred to a specific level of care.

The Health Department's approach comes amid unrest among IB-Salut clinical psychologists. In January, 70 specialists demanded that the Government annul the hiring of 16 psychologists without the clinical specialty who were incorporated into Primary Care centers in Mallorca, Menorca, and Ibiza. The group argued that these additions contravened state regulations and demanded that these positions be filled by specialists in Clinical Psychology.

Clinicians believe that the difference between having a master's degree in General Health Psychology and having completed the PIR is not only educational, but also determines which functions professionals can assume within the public health system. The controversy centers, precisely, on the extent to which psychologists without a clinical specialty can assume psychological care in the public system and which actions should be reserved for specialists. The Health Department is clear: its goal is to bring a psychologist to every health center in the Balearic Islands.