Interns live in and provide services to remote northern communities for half of the internship year and receive supervision from a psychologist in the community, supplemented by telehealth. The department also offers a full-year, postdoctoral rural residency. Ten interns and 4 residents have been trained so far. The community-based generalist training model and responses to the challenges, for both supervisors and trainees, of working in small underserved communities are described.

Access to psychologically informed mental health services has historically been a challenge for the more than 6 million Canadians residing in rural and northern (R&N) communities. However, over the past 20 years, Canada has been witness to a number of positive psychologist-led initiatives aimed at enhancing access for R&N Canadians. These can be grouped into 2 main categories, namely recruiting and retaining psychologists in R&N communities and developing and implementing technologically supported psychology services offered at a distance (telepsychology). This article provides an overview of the barriers to accessing psychologically informed mental health services and reviews some of the psychologist-led initiatives aimed at enhancing access in R&N Canada. Potential benefits and limitations of these initiatives are presented and the importance of enhanced collaboration between urban and R&N-based psychologists is discussed. Finally, psychologists are encouraged to look for and embrace opportunities to further broaden and enhance their positive presence in R&N communities.

Although the literature in rural, northern, and remote (R&N) psychology and professional ethics for this setting is limited, it is clear that this area of psychological practice presents a specific context which must be considered for ethical decision-making. Existing literature suggests that overlapping relationships, community pressure, generalist practice, interdisciplinary collaboration, and professional development concerns are aspects of R&N practice that may be more prevalent. When they are, they pose risks by complicating professional practice and the resolution of related ethical issues. This article highlights the ways that demographic and practice characteristics may instigate ethical issues in R&N professional practice. We briefly review these considerations in relation to the literature, professional ethics, the Canadian Code of Ethics for Psychologists (Code), and case examples from our own practices. More specifically, we discuss how the Code provides guidance in applying the ethical principles to decisionmaking in R&N communities. Further, we suggest practical applications for ethical decision-making acumen inherent in the Code.

The Rural and Northern Program (R&NP) of the University of Manitoba's Department of Clinical Health Psychology (DCHP) is a unique training and service delivery platform that was developed in response to the scarcity of psychological services in rural and northern areas of the province of Manitoba, Canada. Since 1996 rural and northern-based psychologists, in conjunction with the faculty based in Winnipeg (Manitoba's largest city) have offered training to two interns and one postdoctoral resident (resident) yearly. The current article discusses the nature of the program, the regions of Manitoba that the program services, and recruitment and retention data. The authors conclude by offering suggestions for creating sustainable rural/northern psychological practice.

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