Some of the largest, most pressing, and least addressed problems facing Canadians today are threats to their mental health. Every year, approximately 4,000 people die by suicide, placing it 9th among the leading causes of premature deaths within the country. By age 40, half of Canadians have or will have had a diagnosable mental illness. Worse still, these rates are likely to increase as a consequence of the deleterious effects of social isolation on mental health as a result of months of lockdown policies. As such, mental health professionals serve a vital role in society in alleviating the suffering of these individuals, as well as in researching new methods of treatment, prevention of mental illness, and risk factors for the development of mental illnesses. There is certainly evidence of rising demand for the services of mental health professionals, a looming shortage of those professionals, and a surplus in those interested in filling those roles. But how does one become qualified to be such a professional, and can this process be improved? In this analysis, I seek to examine this question and hope to demonstrate that this process, now more than ever due to a looming shortage of mental health professionals, is badly in need of reforms that reduce barriers to entry into the field of mental health.

One of the most common ways for an individual to work in the mental health field is as a psychotherapist. This is someone who treats individuals experiencing problems of a psychological nature and includes not just clinical psychology, but also counselling psychology for those without a diagnosable illness, family or couples therapists, school psychologists, and many others. In order to become a psychotherapist in Canada, a doctorate degree is typically required, though depending on the province and exact type of psychotherapy sometimes only a master’s degree is required.  In order to pursue a doctorate degree, one must first pursue a bachelor’s degree in psychology or a related field. This means that in order to apply for the program needed to practice psychotherapy, one must first complete at the very least 5 years of post-secondary education. After this, they can expect to spend between 5 and 8 years completing their doctoral degree, after which they can begin practicing. These stringent regulations of the mental health field are meant to secure a high standard of care for those seeking mental health services. The field, therefore, requires years of significant personal and financial investment before one can begin their professional career. 

While investment into one’s education is an obstacle unto itself, with university tuition in Canada averaging between 4,000 and 10,000 dollars a year, many are simply lucky to gain entry into these doctoral programs due to their highly competitive nature. Despite psychology being one of the most popular majors for undergraduate degrees, clinical psychology doctoral programs in Canada and the US reject applicants at a rate of 92 per cent primarily due to supervision requirements for doctoral fellows. Consequently, many undergraduate students who will have invested a small fortune in their undergraduate tuition alone are vastly more likely to be rejected than accepted to a doctoral program, though many enroll at the undergraduate level for the express purpose of doing so. Not to mention that a shortage of psychologists is being predicted by the Canadian government over the next ten years due to the impending retirement of many psychologists. A shortage, one might add, likely to be compounded by increased demand due to the effects of the pandemic.

A critical flaw in this system is the disconnect between psychology undergraduate programs and doctoral programs. Modern psychology advocates the ‘scientist-practitioner’ model for psychotherapists, whereby they are meant to be capable both of research and of practicing psychotherapy. Considering that becoming a psychotherapist is one of the first things that come to mind when thinking of a career in psychology, undergraduate programs focus surprisingly little on practitioner aspects regarding the application of psychotherapy, such as counselling. One would expect that a program meant to be the main prerequisite for psychology graduate programs, the sole legal avenue for accreditation in the use of psychotherapy, would include practical components designed to measure students’ interpersonal skills, ability to deal with uncomfortable or deeply personal conversations, and skill in the application of psychological theory and fact. As a final year Psychology undergraduate at McGill, I can attest that for a program that so greatly emphasizes the importance in the research of utilizing measures that accurately reflect the constructs which they intend to measure, there is remarkably little institutional motivation to apply these principles to a classroom setting. 

Undergraduate psychology courses are overwhelmingly theoretical and are heavily reliant on multiple-choice examinations for evaluations. Many courses, including upper-level courses, have no other method of evaluation, meaning the entirety of a student’s grade is the result of a handful of exams. To date, only one of the seventeen psychology courses I have taken at McGill had a graded oral presentation, and only five required any type of paper. None of these five courses were required for graduation. Courses like these that focus more on the application are often much more exclusive, have a limited capacity, and typically focus on the application of skills in research but not in practitionership. While these courses are immensely rewarding to take, it is disheartening that rote memorization of study results, definitions, and criteria are the primary determinant of academic success in most psychology classes at McGill. 

Doctoral programs make acceptance evaluations based primarily based on grades, and these grades are almost exclusively the product of skills that only approximate those indicative of one’s aptitude for a career as a scientist rather than that for a career as a practitioner. This is a concern, as the interpersonal skills required for therapists are not necessarily related to their aptitude for memorization of content. Studies have illustrated that the best therapists are those that are able to form a close bond with their patients, foster an open atmosphere, and behave empathically. These effects can be so significant on the outcome of treatment that a patient seeing one of the top 10 per cent of therapists has twice the probability of recovery, as well as half the probability of deterioration than if they see one of the worst 10 per cent of therapists. The level of empathy a therapist demonstrates alone is thought to account for nearly 9 per cent of the variance in treatment outcome. 

This suggests that if Canada desires a better pool of available psychotherapists, it is worth considering altering the current policy surrounding entry into doctoral programs to include better evaluations for the potential for these traits, or potentially offering a shortened program that requires less investment of prospective attendees.  While this article has emphasized psychology, there are criticisms present that apply to many other arts programs as well. If the role of higher education is purely to further scholarly endeavors, then it has become far too standardized in its evaluation. If it is meant to qualify individuals for positions that require a high proficiency, it does not pay nearly enough attention to what exactly makes an individual proficient for said position. In the case of psychology, if a degree is required to practice psychotherapy, clearly within that context the role of higher education should be that of the latter, and as such, the process needs must be streamlined in such a way that both increases the number of available therapists, solving the predicted shortage, and improve the quality of these therapists.