Opinion: It's still too hard to see a psychologist in Quebec
Updated: May 7, 2021
Recent provincial subcontracting program will help superficially, but actually aggravate the exodus to the private sector.
Over the past decade, an increasing number of psychologists have left their public sector jobs to go work in the private sector, given the lack of proper recognition for their profession. With the $25 million investment in contracts to private psychologists to help decrease psychology wait lists in the public sector, the exodus continues. Unfortunately, the loss of so many psychologists in schools, CLSCs, rehabilitation centres, Youth Protection and hospitals translates into greater suffering and injustice for Quebecers. They are deprived of psychologists’ expertise in development, behaviour, psychopathology and psychotherapy.
Studies show that proper investment in individualized psychological care increases well-being and productivity and decreases societal costs. On the surface, the recent subcontracting program to private psychologists recognizes the need for more psychologists in the public sector to address the six-to-24 month wait times. However, details of this contract actually aggravate the problem. Essentially, it offers private sector psychologists a salary that is significantly more than public sector psychologists (even when including benefits). Private psychologists are also being paid for indirect patient time, which is usually not the case. (In the private sector, psychologists do not usually get paid for discussion time or meetings with other professionals.) Unfortunately, this temporary measure ignores the root of the problem related to the shortage of psychologists in the public sector.
The pandemic has increased psychological distress in the general population. Studies have shown that one in four adults meet criteria for anxiety or depression. The numbers climb to one in two for those ages 15 to 25. Reports to Youth Protection remain high and domestic violence in recent weeks hit a record. Psychologists and physicians have spoken out in the media and pleaded for more investment in psychological services. Physicians have received a disproportionate number of consultations for mental health problems, something they reported having limited training to treat, except with medication. Meanwhile, prescriptions for antidepressants to adolescent girls have increased significantly.
Despite psychotherapy being proven as an effective treatment for a long list of conditions such as anxiety, post-traumatic stress disorder, eating disorders, substance use disorders and depression, accessing psychologists for this treatment is far from easy. Policy makers appear to confuse prevention programs, supportive interventions and psychotherapy. Not getting an effective treatment such as psychotherapy, in a timely fashion, can be detrimental to one’s health.
Although each professional has an important role to play within an interdisciplinary team, mental health professionals are not interchangeable. Patients referred to see a psychologist in their CLSC might need to overcome hurdles and sometimes are not able to access this specialized team member at all. Seeing a psychologist appears to be something accessible only to a small number of people: those financially advantaged who can go to the private sector and those capable of advocating for their rights. The injustice needs to stop.
Mental health disorders need to be treated, given the emotional toll they take on families and the financial consequences they have on our society (ER visits, police calls, violence, unemployment and so on).
The Coalition des psychologues du réseau public québécois (CPRPQ) can help to solve this problem. It is time that we all stand together and demand a real change in our society, where psychological health care is offered equally to all those in need. A real long-term investment in psychological care is needed, one that attracts psychologists into the Quebec public sector and provides conditions that respect their expertise, so they remain available to treat the general population. In order to have a healthier society, we need more psychologists back in our schools, CLSCs, rehabilitation centres and hospitals.
Connie Scuccimarri is writing on behalf of the Coalition des psychologues du réseau public québécois. This article is co-signed by psychologists Catherine Serra-Poirier, Karine Gauthier; Loredana Marchica; Youssef Allami; Béatrice Filion and Vickie Beauregard.