The recently released APS Evidence-Based Psychological Interventions in the Treatment of Mental Health Disorders: A Literature Review is a solid academic effort to consolidate evidence on specific interventions psychologists may use to treat various mental health conditions. My concerns are related to the broad individualistic approach the guidelines have of treating "mental disorder".
The Missing Piece: Social Determinants of Mental Health
One of the most glaring omissions in the APS Evidence-Based Psychological Interventions document is the lack of consideration for social determinants of health (SDOH). Mental health is not just shaped by individual psychological factors—it is profoundly influenced by income, housing stability, employment, education, discrimination, and access to healthcare. Yet, this document focuses almost exclusively on individual treatment models, failing to acknowledge the systemic barriers that contribute to mental illness and affect treatment outcomes. Addressing mental health effectively requires more than therapy alone—it demands a broader, integrated approach that considers the environments in which people live, work, and connect. If we are serious about improving mental health outcomes. Hence interventions should be holistic in nature.
Where is the focus on prevention?
The document centres on treatment after diagnosis rather than on preventing mental illness in the first place. This is a significant oversight. It also neglects the role of psychologists in release prevention.
Strong evidence exists that lifestyle interventions—such as regular physical activity, balanced nutrition, quality sleep, and strong social connections— act as protective factors that may mitigate the risk of developing mental health conditions. Prevention should not be an afterthought but a cornerstone of mental health care. We must stop waiting until people reach a crisis before we act.
Why is lifestyle change not a core part of treatment?
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) explicitly states that lifestyle change is a fundamental intervention in the treatment of mood disorders—alongside psychological interventions.
Yet, this document barely acknowledges lifestyle modifications despite their critical role in improving treatment outcomes, reducing relapse rates, and enhancing overall well-being. Exercise, sleep, nutrition, and social connection are not "alternative" therapies but evidence-based necessities.
Where is the collaboration in treatment?
Even when people do require treatment, mental health does not exist in isolation. Yet, this document fails to recognise the role of other healthcare professionals—physicians, dietitians, exercise physiologists, social workers, and others—who all contribute to mental well-being.
If a psychologist doesn’t deliver a treatment, does that mean it shouldn’t be part of the conversation? This mindset limits patient care. Many people struggling with mental health challenges also need:
- Exercise physiologists to improve energy, sleep, and mood
- Dietitians to address the gut-brain connection and reduce inflammation
- GPs to identify underlying medical issues contributing to symptoms
- Sleep specialists to address insomnia, which is often a key driver of mental distress
- Community Interventions - ensuring clients know of the range of community and other options that may be available.
We are not operating outside our scope of practice when we inform people of evidence from other fields and make appropriate referrals.
Evidence-Based Practice ≠ Professional Protectionism
True evidence-based practice is not about protecting professional boundaries—it’s about doing what works. We must break down professional silos and embrace a truly integrated, prevention-focused model of care.
I am optimistic that, at some point, we will move towards a more comprehensive evidence-based approach—one that acknowledges the contributions of other disciplines and the critical importance of collaboration and coordination in client/patient care.
I am aware that the above issues may be considered 'out of scope' of what the guidelines were designed for as they are about psychological interventions - yet I think that demonstrates my point.