Tuesday, March 23, 2021

Actions don’t meet rhetoric on mental health

The provincial government has stated it wants to make the necessary changes and investments to help improve the quality of mental health services in the province.
However, their actions and words don’t seem to matchup.
For instance, journalists noted politicians laughing during a debate in the legislature concerning mental health last week. This shows some elected officials don’t grasp the severity of the situation or are unconcerned about a very serious topic.
Then came the budget. While government framed that it was making additional investments in mental health services, in actuality, it’s percentage of spending on mental health was the same as it was the year prior. Again, it’s actions are not meeting it’s words.
Next was the introduction of amendments to the Education Act to, “empower the school system and provide increased support for teachers and students,” according to a government press release.
One of the proposed amendments would allow for teachers to administer psychological and psychoeducational tests, score and interpret the results.
This problematic on so many levels and demonstrates the province is not taking the issue of mental health seriously.
Here are the issues with this proposal from the College of Psychologists of New Brunswick (CPNB):
Lack of consultation of key stakeholders. The first reading of Bill-35 occurred without any prior consultation with key stakeholders such as CPNB, NB Teachers Association, the Learning Disabilities Associations, etc., and without appropriate collaboration with the Department of Health that would house expertise related to psychological/psychoeducational assessments. There was no due diligence, especially given NB would be the first province to constitute this type of legislation.
Lack of understanding of assessment illustrated in the legislation. The description of psychoeducational assessment in the proposed legislation as to “administer a test prescribed by regulation, score the test and interpret and apply the results of the test... 25.1 For the purposes of section 11.1 of the Act, the test that may be administered is the Wechsler Intelligence Scale for Children (WISC).” demonstrates the Department of Education’s ignorance of the exact process it is trying to legislate. First, psychoeducational assessments are in no way as simple as administering, scoring, and interpreting a test. Second, mental health problems can affect learning and results on these tests. An individual with symptoms of anxiety, depression or autism, for example, might also struggle with schoolwork, test-taking, attention and concentration, behaviour in the classroom, etc. Teachers are not qualified to assess mental health problems and providing them with the tools to do only part of a psychoeducational/psychological assessment creates more problems than it solves. It is a recipe for incorrect conceptualizations of a child’s existing challenges and their cause, and therefore a recipe for harm to children.
Significant risk to the public. Contrary to psychologists, teachers – even those with a master’s degree – do not have the multi-year university training and supervision required in psychological and psychoeducational assessment. Asking them to do an activity that they are not sufficiently trained and supervised to do poses risk to them (liability) and to their students by creating situations that (a) increase the likelihood of misinterpretation of information, (b) leave prescribing physicians and parents/guardians with only partial information (strengths and weaknesses that may or may not be accurate, lack of attention to other mental health factors that might have impacted the results), and (c) encourage teachers to suggest diagnoses, which is well beyond what they are qualified to do and increases the risk for misdiagnosis. At a time when the government is under scrutiny for their lack of sufficient attention to mental health, it is unwise to further dilute the quality of mental health care being provided.
Alienation of psychologists. This legislation represents a clear disrespect for the training, knowledge, and skills of psychologists. The province is facing a labor market shortage in psychologists; this is not the time to further alienate this important professional group. This lack of respect for psychologists’ scope of practice is exactly what drives psychologists out of the public system, and, even further, out of the province. These concerns have been well-documented in CPNB’s Working Conditions Report (2018). The lack of psychologists in the province and in the public sector creates further risk to the public.
Lack of clarity in legislation. The lack of clarity in this legislation also raises significant concerns. What is the approved training that would be involved in learning how to do these assessments? The only people qualified to administer this training are psychologists, and they are prohibited from teaching non-psychologists how to use these tests without close and immediate supervision given the aforementioned risks to public health posed by misuse of the tests. Furthermore, who is the acting expert advising the Minister to determine what degrees and training would be approved?
Conflict of interest. As part of implementing this legislation, the Department of Education has indicated a collaboration with Pearson Canada Assessment Inc., the company that produces and sells the regulated tests used in psychoeducational assessments. This represents a major conflict of interest. It is no surprise that a for-profit company would like to extend the number of people to whom they can sell their tests. That does not mean that it is in the best interest of New Brunswickers. Corporations do not protect the public. They aim to maximize profits.
The New Brunswick Union completely agrees with CPNB and are against this amendment. We suggest the Minister of Education prioritizes making sure children are properly assessed and diagnosed by qualified professionals.
This means better recruitment and retention of trained psychologists into the public sector, not downloading the work of these professionals onto teachers who have enough on their plate.