Hospital psychology in Canada: An update.

Abstract

This study updates the state of knowledge regarding hospital psychology in Canada. Since 1982, two surveys have examined psychology and the role of psychologists within Canadian hospital settings; the most recent information was collected in 1999. Since 1999, the structure of Canadian health care has continued to change and develop, and the resulting impact on the status of hospital psychology remains unknown. This article presents information collected from 76 acute care facilities across Canada with respect to the provision of psychological services within the hospital setting, education levels, scope of practice, salary range, organisational structure, and criteria for hiring employees and accepting residents. Results indicate that the range of services offered by hospital psychologists has not undergone expansion since 1999, although changes in employee remuneration, theoretical orientation, and administrative models are evident.Keywords: hospital, health care, professional psychology, education, salary, professional practiceSince 1982, two surveys have been conducted on the roles of psychologists within hospital settings in Canada. In the original survey, Arnett, Martin, Steiner, and Goodman (1987) identified that psychologists had begun to make significant and recognised contributions to health care in a wide range of clinical, educational, and research areas (p. 168). Humbke et al. (2004) replicated and extended the initial survey almost two decades later; demonstrated that psychology had continued to expand its presence within Canadian health care; and had undergone changes in educational requirements and standards, treatment orientations, and level of autonomy within hospital systems. However, the evolving nature of psychology and the Canadian health care system has meant that these survey results are quick to become obsolete. More current information on the status of hospital psychology in Canada is due.As discussed by Humbke et al. (2004), a number of developments took place following the publication of the original survey (Arnett et al., 1987), and these developments have continued to impact the practice of psychologists in Canadian health care settings. Hearns and Evans (1993) described these developments as (a) the introduction of licensing requirements in every Canadian province; (b) the addition of a psychology department review for hospital accreditation; (c) the introduction of standards for internship program accreditation by the Canadian Psychological AssoThis ciation; (d) the implementation of measures to improve cost efficiency of psychological services, including workload tracking systems; and (e) ongoing changes in administrative organisation of psychologists in health care settings to enhance clinical, research, and organisational functions. Another more recent development that may have changed the landscape of hospital psychology in Canada was the development of the Mental Health Commission of Canada (Mental Health Commission of Canada, 2009). Part of the Commission's strategy is to move toward community-based mental health care and to rely less on the provision of mental health services through hospitals or acute care facilities. Currently, it is unclear whether the goals of the Commission have slowed down or even reversed the pattern of growth for psychologists working in hospitals.Given the ongoing development of the Canadian health care system and mental health care in particular, it is essential to continuously update our knowledge regarding the roles and responsibilities of psychologists practicing in Canadian hospital settings. First, as psychology continues to move away from the traditional focus on mental health and toward nontraditional specialties in general health care settings, it may become increasingly difficult for the discipline to maintain its identity (Goodman, 2000). The expanding role of psychology in health care has resulted in a challenge for psychologists, health care professionals, administrators, and the general public, to identify and understand the services that psychologists are providing in hospital settings. …