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By David L Stokes MAPS, Manager - Professional Issues

The World Health Organisation (2004) defines rehabilitation as "a proactive and goal-oriented activity to restore function and/or to maximise remaining function to bring about the highest possible level of independence, physically, psychologically, socially and economically. It involves combined and coordinated use of medical, nursing and allied health skills, along with social, educational and vocational services, to provide individual assessment, treatment, regular review, discharge planning and follow-up. Rehabilitation is concerned, not only with physical recovery, but also with psychological and social recovery and reintegration (or integration) of the person into the community". Psychologists are eminently placed to assist in facilitating the achievement of maximal rehabilitation outcomes.

Currently the skills of psychologists are under-utilised in the public health systems of Australian States and Territories, a situation that has both direct and indirect consequences for patients and public health. There is substantial evidence of the efficacy and cost effectiveness of psychological interventions in both general medical, rehabilitation and mental health settings, that has not been reflected in the services provided in publicly funded health services. Members of the public who use such services are therefore disadvantaged and health services are not capitalising on potential cost savings associated with psychological interventions. Nationally, the achievement of less-than-optimal performance of the rehabilitated person adds significantly to the cost of production of goods and services within Australia.

Psychologists are trained to provide specialist assessment, differential diagnosis and therapeutic interventions for a variety of medical, neurological and mental disorders. They assist in the management of a range of cognitive, behavioural and adjustment difficulties, provide education and training to patients, carers and staff, and are involved in health promotion, including the provision of change strategies for health risk behaviours. Interventions may be offered to individual patients, patient groups or family groups as appropriate.

A paper has been prepared by a Working Group of the APS Directorate of Professional Issues on the role psychologists can play in various domains of health care and rehabilitation. Each section of the document provides a brief summary of the ways in which psychologists can contribute to health and rehabilitation in a variety of health settings such as health education, acute and long-term hospital care, rehabilitation and community health care. References are provided at the end of each section to allow individuals working within specific health areas to access the information most relevant to them, and where necessary provide colleagues or employers with an overview of the impact psychologists can have in specific health areas of interest.