What is the best way to improve access to psychologists in Canada?

The number of hours required to start working as a psychologist seeing patients in Ontario could be reduced under proposed changes aimed at boosting the supply of health professionals in the province.

The College of Psychologists and Behavior Analysts of Ontario (CPBAO), which regulates professionals, says Ontario lags behind Alberta and Quebec in the availability of psychologists, causing people to wait longer for care.

To address the gap, the college recommends Ontario “modernize” by cutting training hours to obtain licensure, eliminating oral exams and moving away from ethics exams. Now, an advocacy group of psychologists is pushing back, warning that people won’t get the care they need — and the move could be risky for vulnerable patients.

In October, Canadian Institute for Health Information Reported about one in 10 people waited for Four months or more for community mental health counseling between 2020 and 2024.

There are about 1,600 in Ontario mental health and substance use providers per 100,000 residents, lower than many other provinces. of ontario Auditor General Intensive treatment was found for children and young people who experience inability to function because of their mental health Problems stood at 105 days in 2023/24, up from 94 days a year earlier.

The need for special care arises when wait time For community mental health counseling may be longerR for children and youth compared to adults.

Symptoms can reach the ceiling

Psychologists diagnose and treat a wide range of patients and clients, including children, youth, and adults with mild to very severe mental health problems and illnesses.

For example, a licensed psychologist with less training may misdiagnose a child with ADHD when they actually have PTSD and an anxiety disorder, the symptoms of which may be similar to someone who doesn’t have the experience to differentiate, said Dr. Jane Bosio, a clinical and health psychologist in Kingston, Ontario.

“If we incorrectly assume that someone has ADHD and then it escalates, let’s say the child is being given a stimulant like an ADHD medication… but they actually have PTSD and an anxiety disorder, then it can exacerbate their symptoms. It can make things more dangerous.”

Psychologists also point out that distinguishing memory loss from depression and dementia requires a level of expertise that other mental health care providers do not evaluate.

When people struggle with very serious mental health concerns, the risks are not insignificant and include a higher risk of dying by suicide and having long-term or worsening disability, said Bosio, a spokesperson for the Psychology Advocacy Network.

‘Unnecessary obstacles’

The college says eliminating unnecessary delays in getting qualified professionals to practice can help Ontarians of all ages gain access to qualified, skilled and competent psychological and behavioral care.

Tony Debono, registrar and executive director of the College of Psychologists and Behavior Analysts of Ontario, said that currently, the province requires master’s-level graduates to complete four years. non-evaluative observation Work experience, followed by one year of supervised practice, before becoming a psychology associate. This is compared to one year of supervised practice in jurisdictions such as Alberta, Saskatchewan, Northwest Territories and Yukon.

“This requirement creates unnecessary barriers, drives graduates out of Ontario, and conflicts with national labor mobility and free trade agreements,” Debono said.

Maryanne Istiloglou, executive director of the Ontario Association of Mental Health Professionals, supports the proposal for master’s-level psychologists, which she said is long overdue.

“I think this is the right step,” Istiloglu said. “Psychologists who have a college license are competent and effective and really good at what they do.”

Psychiatry coverage and inequity concerns

Mental Health Commission of Canada Long wait times for public services result in most people having to pay out-of-pocket for psychotherapy, while the UK and Australia introduced nationwide programs that increased no- or low-cost access to psychotherapy for people suffering from mild to moderate depression and anxiety.

Canadian Psychological Association Has called for more workplace insurance coverage for psychologists. And a report by the Public Health Agency of Canada points out that Lack of public health insurance coverage The treatment of mental health conditions by non-physicians in all provinces and territories and access to employer-paid insurance as factors contributing to disparities.

The Canadian Psychological Association calls for change Registration Requirements For psychologists and psychology associates, removing the doctoral standard recognized by this is not the way to go.

Canadian Psychological Association CEO Lisa Vota-Bleeker instead called for a conversation on investment in publicly funded institutions to address gaps in labor mobility. Registration restrictions.

Provincial health ministers discussed the ability for various health-care professionals, such as physicians, to work more easily in many provinces at their October meeting and closing news conference.

However, the office of the Ontario Minister of Health stated that the proposal to reduce training hours was developed and put forward by the CPBAO.

“This is not the result of any government legislation and we have no plans to make any such change,” said Emma Popovic, a spokeswoman for Ontario’s health minister. “The scope of practice consultation currently underway applies to each regulated health profession based on their existing standards.”

The college’s consultation will run until December 9, with the final decision relying on the college’s board and Ontario’s Minister of Health.