A group of psychologists, psychological associates, psychology graduate students and community members rally against proposed changes to lower Ontario's psychology training standards, in Toronto on Saturday.Sammy Kogan/The Globe and Mail
Consultations on plans to lower training requirements for psychologists in Ontario will end Tuesday, but clinicians fear the proposed changes will lower standards and compromise patient safety.
The amendments to training benchmarks have been proposed by the College of Psychologists and Behaviour Analysts of Ontario, which regulates psychologists, psychological associates and applied behavioural analysts in the province.
The CPBAO is planning to, among other things, reduce the required amount of supervised work for registrants without doctoral-level training to 12 months from four years. Other changes include the discontinuation of an oral exam.
The proposed reforms, it says, are designed to increase availability of psychologists in Ontario and bring the province’s training in line with other jurisdictions. Alberta, Saskatchewan, the Northwest Territories and Yukon require just one year of supervised practice for master’s level applicants.
Many psychologists take issue with the planned shift, however, and dozens protested against the changes on Saturday in both Toronto and Ottawa. The CPBAO’s council said it plans to consider the comments from the consultations before it makes submissions to the Ontario Ministry of Health.
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Several independent organizations that represent mental-health practitioners voiced their apprehension in recent public statements.
Ahead of the demonstrations, the Psychology Advocacy Network said clinicians across the province were concerned the amendments will “result in a generation of psychologists who are not adequately prepared to support the needs of the public.”
The changes, it added, could “reduce the quality of psychological services, undermine public trust and create significant risks for patients and clients.”
The Ontario Psychological Association has warned that the plan compromises safety in the name of greater access. The CPBAO’s proposals, it said, “strip away educational standards and safeguards, flooding the system with undertrained clinicians and putting the public at risk.”
The Canadian Psychological Association wants the college’s proposal to be withdrawn. Canadians should expect expert care when they see a psychologist, said Lisa Votta-Bleeker, the CPA’s chief executive officer.
“No one would ever suggest that we reduce the training required to become a physician to address a shortage of medical providers,” she said in a statement.
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Many health care organizations are also concerned about the Ontario government’s September announcement that it was consulting on expanding the scope of practice for a range of regulated health professionals, including psychologists.
The province said the approach would improve wait times and reduce pressure on the health care system.
As part of the consultations, Ontario said it would look at allowing individuals with postdoctoral Master of Science degrees in clinical psychopharmacology prescribe select psychotropic drugs for the management and/or treatment of mental health conditions and addictions.
It also said it is considering letting the same psychologists order and interpret laboratory tests, such as bloodwork and urinalysis to help with drug monitoring.
Erin Ariss, a registered nurse and president of the Ontario Nurses’ Association, said in a letter to provincial Health Minister Sylvia Jones that the proposals raise several challenges, especially when viewed in tandem with the suggested training reforms.
“Considering the significant reductions to education, training and supervision standards, expanding the scope of practice to include prescribing psychotropic medications and ordering diagnostic tests is not evidence-informed,” Ms. Ariss wrote.
The College of Family Physicians of Canada and the Ontario College of Family Physicians have also urged the province to reconsider the proposed scope-of-practice changes. The organizations acknowledge a need for system improvements. However, in a joint statement they said such “reforms achieve best results when aligned with team-based care.”
At the time of Ontario’s announcement, Tony DeBono, registrar and chief executive officer of the College of Psychologists and Behaviour Analysts of Ontario, said expanding the scope of practice of psychologists with specialized training could improve access to mental health and addiction care.