No abstract

There have been persistent calls for increased representation of Black, Indigenous, and People of Colour (BIPOC) in all aspects of the psychology workforce. For equity to occur in the profession and delivery of services, there must be equity in access to graduate-level training in psychology. In this article, we discuss systemic racial inequity in access to Canadian psychology graduate programmes. We reviewed literature to investigate admissions evaluation criteria for racial bias using the University of Ottawa, School of Psychology's publicly available ranking grid as an example. This scoring grid provides a transparent evaluation process that includes elements common to many Canadian programmes. We reviewed literature relevant to predictive validity and racial bias in the grid elements. Our review was guided by two questions: (a) What evidence is there that ranking grid items and other commonly used admissions criteria predict psychology graduate student success? (b) Do the criteria maintain systemic racial bias in the selection of graduate students? We found that all items on the admissions ranking grid were biased, suggesting that racial bias in admissions criteria maintains systemic racism against BIPOC applicants. We propose both concrete and policy/advocacy recommendations to improve access to psychology graduate education for BIPOC groups; these recommendations may benefit other underrepresented groups as well. Public Significance StatementBIPOC are disproportionately underrepresented in Canadian graduate psychology programmes, resulting in few BIPOC working in psychology professions in Canada. This lack of representation has devastating impacts on the profession of psychology as a whole (e.g., lack of diverse thought), and importantly, the health of racialized communities (e.g., lack of culturally appropriate practices and services). The recommendations provided herein can inform changes in policy and procedures to promote racial equity, diversity, and inclusion in the field of psychology.

Studies from the United States and United Kingdom show that Black patients are disproportionately diagnosed with psychosis and receive excess coercive medical intervention. There has been little discussion of this topic in Canada, and of how coercive interventions may have influenced Black patient attitudes towards mental health services. To address these issues, semi-structured interviews were administered to five Black men with first-episode psychosis (FEP) to (a) explore their experiences with coercive interventions and (b) describe how these experiences may have influenced help-seeking behaviours. Interpretative phenomenological analysis (IPA) was used to analyze the data. Four core themes and four additional themes emerged from the interviews. Patients described loneliness, not being heard, police contact and forced medication as influencing their attitudes towards mental health care. Further research is needed to develop reparative strategies to encourage reflection about and awareness of coercive intervention among Black FEP patients.

Objectives Rural primary care practitioners (PCPs) have a pivotal role to play in frontline pediatric mental health care, given limited options for referral and consultation. Yet they report a lack of adequate training and confidence to provide this care. The aim of this study was to test the effectiveness of the Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program, which was designed to enhance PCPs’ pediatric mental health care confidence. The program includes brief therapeutic skills and practice guidelines PCPs can use to address both subthreshold concerns and diagnosable conditions, themselves. Methods The study design was a pilot, cluster-randomized, multicenter trial. Practices were randomly assigned to intervention ( n practices = 7; n PCPs = 42) or to wait-list control ( n practices = 6; n PCPs = 34). The intervention involved 8 hr of training in practice guidelines and brief therapeutic skills for depression, anxiety, attention deficit hyperactivity disorder, and behavioral disorders with case discussion and video examples, while the control practiced as usual. A linear random-effects model controlling for clustering and baseline was carried out on the individual-level data to examine between-group differences in the primary (i.e., confidence) and secondary (i.e., attitude and knowledge) outcomes at 1-week follow-up. Results Findings were a statistically significant difference in the primary outcomes. Compared to the control group, the intervention group indicated significantly greater confidence in managing diagnosable conditions ( d = 1.81) and general concerns ( d = 1.73), as well as in making necessary referrals ( d = 1.27) and obtaining consults ( d = 0.74). While the intervention did not significantly impact secondary outcomes (attitudes and knowledge), regression analysis indicated that the intervention may have increased confidence, in part, by ameliorating the adverse impact of negative mental health care attitudes. Conclusion PTCAP enhances PCPs’ child/youth mental health care confidence in managing both general and diagnosable concerns. However, an 8-hr session focused on applying brief therapeutic skills was insufficient to significantly change attitudes and knowledge. Formal testing of PTCAP may be warranted, perhaps using more intensive training and including outcome assessments capable of determining whether increased PCP confidence translates to more effective management and better patient outcomes.