Psychology grad students in limbo while Eastern Health residency program on hold

On the surface it seems like an easy solution — psychology students want to stay and work in Newfoundland and Labrador at the same time the province is crying out to fill vacancies. 

But CBC News has learned one of two residency programs in the province is on hold because there aren't enough psychology supervisors to run it, leaving students like Elizabeth Wallack looking for a backup plan.

"All of my training and practicum leading up to this point was really tailored to be able to be competitive for matching with Eastern Health," said Wallack, a third-year doctoral psychology student.

"But unfortunately, the program has been suspended and it happened in the year that I was intending to proceed with my training, so I'm delayed by a year."

Eastern Health began offering a 12-month pre-doctoral residency in clinical psychology in 2012 and was accredited in 2015 by the Canadian Psychological Association. 

Thirty-six students have graduated since then, and an internal document obtained through an access-to-information request said the program has led to 36 per cent of those students staying to work in the field in the province. 

The CPA renewed Eastern Health's accreditation in May 2021, but noted in a separate report also obtained through an access-to-information request that students were concerned about high supervisor turnover. 

"It seems evident that current short-term adjustments/coverages by the supervising psychologists cannot be sustained long term without adjustments and additional resources/support being provided to the faculty and the program," the report noted. 

The health authority decided to abandon the program for the 2022-23 year as it struggled to find the staff needed to provide instruction to students.

A report provided to Eastern Health's vice-president of clinical services Collette Smith dated June 2021 said there had been six resignations of supervisory staff in the 2020-21 year, and an additional seven resignations in the four years prior to that. 

"In order to increase the number of fully registered doctoral-level supervising psychologists available to the residency program, Eastern Health must recruit clinical psychologists," the report said.

"The majority of newly recruited psychologists are provisionally registered psychologists, which means that they require one year of intensive supervision by a fully registered staff psychologist before they can supervise residents."

Information on what actions are being taken to address the inactive year is redacted from the documents.

CBC Investigates reported Wednesday that the health authority is facing a near 45 per cent vacancy rate in psychology positions, as the mental health specialists leave for private practice. Some psychologists who have left noted there are long-standing issues within the health authority, which led to a mass exodus from the public system. 

What now?

The next step in Wallack's schooling would have been a yearlong internship in September to finish her pre-doctoral training — a requirement necessary to become a registered psychologist. 

Memorial University's Student Wellness and Counselling Centre also has an accredited psychology residency program but it isn't geared toward the clinical psychology work in which Wallack and some of her colleagues plan to practise.

"Right now, the study program at Memorial is doing an exceptional job of attracting students who want to train and remain in the province. And that residency really is that critical intermediary step to allow them to stay here," Wallack said. 

One colleague has already chosen to go outside the province, while the others are being forced into a fourth year, without any guarantee the program will resume anytime soon, Wallack said.

Wallack is married with a child and owns a home here. Leaving her home province would create a massive burden, so she is attempting to find a private psychologist who would be willing to take her on.

"The fact that we are not provided with a kind of more co-ordinated and concrete process to be able to cross that finish line here in the province and keep these incredible people, it just seems like a real missed opportunity," she said.

"And as a Newfoundlander, it makes me kind of sad to see these awesome people kind of slip through our fingers and leave the province again."

Wallack said a little collaboration could go a long way to match students in advance with those difficult-to-fill positions that have been sitting vacant. She hopes the provincial government, university and health authority can come together to find a solution that works for everybody. 

'It's in a crisis'

The erosion of the number of public health psychologists has been a gradual process that began before COVID-19, said Dr. Janine Hubbard, a registered psychologist and president of the Association of Psychology Newfoundland and Labrador. 

"It's in a crisis and I don't use that word lightly," Hubbard said in a recent interview.

"We are literally on the verge of not being able to train and retain a new generation of psychologists."

Hubbard said the association has been warning the provincial Health Department of an impending decline in the psychology workforce for years.

It is critical that the program continue in order for new psychologists to experience living and working here, with the hope that they will stay, Hubbard said.

Patients, she said, are the ones who are shouldering the burden. 

"There are people falling through the cracks. And something that often gets lost is that someone experiencing significant mental health challenges is every bit as potentially life-threatening as the cardiac conditions that we've been hearing about," she said.

Health Minister John Haggie declined to do an interview for this story.

However, when asked during an unrelated news conference about the residency program and its future in the province, Haggie acknowledged that a lack of psychologists has led to the program being paused. 

"The issue there is critical mass. We need to have people with enough time and the qualifications to actually mentor and preceptor during that program," Haggie said.

"We've seen people change their work styles through COVID and psychologists are no different than any other health-care providers so we are aware of the issue."

Haggie said there will be a longer-term plan, but in the meantime there are recruitment efforts underway in the short term. 

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