With services strained, public health psychologists consider leaving the sector, says association

Anxiety and depression have reached crisis levels in Newfoundland and Labrador, according to the provincial association of psychologists, which says a spike in demand for services has left many people without a therapist.

In a February survey, the Association of Psychology Newfoundland Labrador collected data that suggests demand is on the rise, wait-lists are full and many people can't get the help they need.

"It's unprecedented. While we're delighted that people are reaching out — we've worked really hard on decreasing the stigma — what we are finding is that services just aren't available," Dr. Janine Hubbard, president of APNL, told CBC News on Tuesday.

"As someone who has to turn away individuals, it's heartbreaking because we know they're in crisis, we know they're reaching out for help."

The situation is compounded by psychologists leaving the public health system, which is straining private care as patients are funnelled into that sector, said Hubbard. There are currently 211 registered psychologists in Newfoundland and Labrador in public and private health.

The APNL survey suggests psychologists are leaving the public sector because of frustrations with the system. Just over 52 per cent of those working in public health who responded to the survey said they recently considered leaving their jobs.

When asked what it would take to change the minds of those considering leaving the public sector, the most common responses were increased respect, increased autonomy, better understanding of the role, education and/or skills of psychologists, increased salary, increased opportunities to use psychology skills and increased financial support for education and training opportunities.

Thirty-one per cent said they're considering a full-time private practice, and 12 per cent said they're considering leaving the province entirely.

In some public-sector areas, such as education, health and post-secondary, there are vacancies of 30 to 50 per cent, Hubbard said.

"This isn't just related to COVID," she said. "This has been going on for the past five, six years."

In a statement to CBC News, the Department of Health said clinical psychologist vacancies are concerning and challenges persist in regional health authorities across the province.

The department said the health authorities are "directly responsible for the administration and delivery of health services" — including responsibility for human resource management, staffing and recruitment — and it's working with them on how to address the issues.

There are currently about 35 vacant positions in regional health authorities, the department said.

Consultation and retention

Hubbard said psychologists are feeling the same frustrations as other health providers, with things such as burnout, inability to practise to their full scope and structural changes being imposed without any input or consultation being concerns near the top of the list.

"We're actually well trained in things like program evaluation and program design. If changes are being made, we're just asking to include us at those early planning stages," Hubbard said.

"There's a real need to focus on … retention issues for the mid-career and senior level psychologists."

The Health Department said it has engaged psychologists throughout development of its provincial "stepped-care model" — which aims to match individuals with the right level of care, at the right time — under the Towards Recovery Action Plan. The department said it has ensured psychologists' involvement throughout the entire development process with representation on the provincial stepped-care committee.

As for retention, the Health Department said an assistant deputy minister of health position for professional recruitment and retention has been created to help attract health-care professionals to the province.

"Recruitment and retention of psychologists and other health professionals are ongoing issues for many jurisdictions around the world. The situation here, in Newfoundland and Labrador, is no different," the statement reads.

"Clinical psychologists are considered an 'in demand' occupation under the Priority Skills N.L. initiative of the Office of Immigration and Multiculturalism. Internationally trained clinical psychologists were invited to complete an expression of interest and there has been limited interest to date."

The Department of Health said the provincial government has also bumped bursaries to $20,000, available to students enrolled in psychology education programs who agree to complete a service commitment in one of the province's health regions. The department said it's working with regional health authorities to address competitiveness with the private sector as well as publicly employed psychologists in other jurisdictions.

CBC News asked each of the province's four regional health authorities for comment Tuesday. No comment had been received by publication.  

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