WHEREAS rural Alberta is under-served by mental health professionals, and the need for qualified, comprehensive, and accessible mental health services are desperately needed throughout Alberta; and
WHEREAS despite promises made by successive provincial and federal governments to improve mental health services for all Albertans, rural Alberta continues to be underserved without any substantive change; and
WHEREAS the need for readily available and quality mental health services is growing continuously, as can be seen by growing homeless populations, increasing drug dependency, correlated increases in property crimes, overloaded law enforcement, and judicial systems; and
WHEREAS there is currently no eligibility for the Canada Student Loan forgiveness program for provisional psychologists and psychologists who are members of the Alberta Psychologist Association; and
WHEREAS currently professional counsellors registered with the Canadian Counselling & Psychotherapy Association with practices located in rural Alberta do not qualify for the Canada Student Loan forgiveness program; and
WHEREAS currently in Alberta there are no minimum standards or governing body for practicing counsellors; and
WHEREAS the Association of Counselling Therapy of Alberta has been petitioning the Government of Alberta to regulate professional counsellors practicing in Alberta by establishing a College of Counselling Therapy of Alberta; and
WHEREAS regulating counsellors holds them to professional standards and subjects them to a disciplinary process should these standards be breached, thereby ensuring vulnerable Albertans are not exposed to potentially harmful or poor-quality services; and
WHEREAS due to the lack of a regulating body, qualified professional counsellors are often not recognized by employee assistance programs for reimbursement; and
WHEREAS many rural Albertans are required to travel long distances and pay out of pocket for counselling services, making the service difficult or impossible to attain for many individuals;
THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta (RMA) request that the Government of Alberta advocate to the Government of Canada to add provisional psychologists, psychologists, and registered counsellors with the Canadian Counselling & Psychotherapy Association to the list of qualifying professions for the Canada Student Loan Forgiveness program, provided that their professional practices are located within a designated under-served rural or remote community within Alberta;
FURTHER BE IT RESOLVED that the RMA urges the Government of Alberta to work in conjunction with the Association of Counselling Therapy of Alberta to create a regulatory body that would be responsible for developing, maintaining, and enforcing regulations, standards of practice, and codes of ethics to protect the public in the Province of Alberta.
Over the past number of years, all levels of government have acknowledged the growing need for mental health services. While there have been some attempts at improving mental health services across Alberta, none of these efforts have contributed significantly to improving rural Albertans’ access to services compared to our urban neighbours.
While recognizing that health services are the domain of the provincial and federal governments, it is incumbent upon local municipal governments to hear our residents’ requests for help, recognize the need for action, and advocate to senior government levels. In the past municipal governments across Alberta advocated for increased numbers of rural doctors, and in response, a Student Loan Forgiveness initiative was created.
Only health professionals, such as nurse practitioners, licensed practical nurse, registered nurse, registered psychiatric nurse, family doctors, family physicians, and family medicine residents practicing in designated under-served rural or remote communities, qualify for the Canada Student Loan forgiveness program.
In an effort to increase mental health services in rural and remote portions of Alberta, we would encourage the Government of Alberta to consider advocating to the Government of Canada to add provisional psychologists, psychologists, and professional counsellors registered with CCPA to the list of professions that qualify for the Canada Student Loan forgiveness program. This benefit would encourage these professionals to consider rural Alberta locations for their practices.
The Association of Counselling Therapy of Alberta (ACTA) has been working to create a regulatory body to govern counselling therapy, much the same as The College of Physicians & Surgeons of Alberta (CPSA) regulates doctors in Alberta. However, the province advised ACTA in September 2021 that the College of Counselling Therapy of Alberta (CCTA) was no longer a priority for the government.
This is concerning as it leaves no regulation as to who can market themselves as a counselling therapist, as well as no minimum standards or practices for those that choose to provide counselling therapy. Further, it leaves vulnerable Albertans exposed to potentially harmful or poor-quality services and impacts how insurance providers and employee assistance programs view counselling therapy in Alberta. This can also mean residents must travel long distances to receive these services in larger city centers. This is impractical and expensive and can lead to someone failing to obtain needed therapy. Without a regulatory body, anyone may present themselves as a counselling therapist as there are no professional standards to subject them to nor any disciplinary process for unsafe practices. Further, these added non-professionals distort the numbers, which may cause inappropriate estimations of accurate counselling services available to residents.
We would encourage the Government of Alberta to expedite working with the ACTA to create a governing body for counselling therapists in Alberta for the service and protection of all Albertans.
RMA has no active resolutions directly related to this issue.
Alberta Advanced Education
Thank you for your letter to the Honourable Kaycee Madu, Deputy Premier and Minister of Skilled Trades and Professions, regarding RMA’s Resolution 8-22F: Rural Mental Health Advocacy. As I am the Minister of Advanced Education, responsible for student aid, Minister Madu has asked me to respond to the portion of Resolution 8-22F focused on student aid, and appreciate the opportunity to do so.
Alberta’s government is aware of the challenges rural municipalities are facing attracting and retaining mental health professionals. We are also aware of the challenges facing rural Albertans when trying to access mental health professionals within or close to their communities. I can assure you that the government is taking urgent action to ensure Albertans have access to world-class healthcare. The Healthcare Action Plan was recently announced and identifies immediate government actions to build a better healthcare system in Alberta. Please visit the Alberta government’s Healthcare Action Plan website at www.alberta.ca/healthcare-action-plan.aspx to learn more.
The Ministry of Advanced Education is committed to ensuring student loan repayment remains affordable. Although Advanced Education does not provide loan forgiveness, the ministry does provide several supports to help borrowers manage their loan payments. This includes making student loans interest-free and payment-free while students are actively in studies and for six months after they complete their studies. These benefits are available to all Alberta student loan borrowers regardless of their profession or income level.
The Canada Student Financial Assistance Program has a loan forgiveness program for specific medical professionals. It is important to note that this program applies to a borrower’s Canada student loan only. You can find more information about Canada student loan forgiveness, and which communities qualify as rural, on the Government of Canada’s Canada Student Financial Assistance Program website.
As the Canada Student Financial Assistance Program is managed by the federal government, my ministry is unable to make any changes to the list of qualified professionals. Alberta is a member on the Inter-governmental Consultative Committee on Student Financial Assistance, a pan-Canadian table, providing advice and advocating provincial perspectives toward federal student financial assistance policy. I can assure you that my ministry staff will advocate at committee and subcommittee forums that provisional psychologists, psychologists, and registered counsellors with the Canadian Counselling and Psychotherapy Association should be considered for student financial assistance.
The first resolved clause in this resolution calls on the Government of Alberta to advocate to the Government of Canada to add provisional psychologists, psychologists, and registered counsellors with the Canadian Counselling and Psychotherapy Association (CCPA) to the list of qualifying professions for the Canada Student Loan Forgiveness program. To be eligible for the program, practices must be located within a designated underserved rural or remote community within Alberta. The second resolved clause is dealt with below.
The decision to regulate the profession of counselling therapy involves extensive consultations with various interest groups and within the health care system in order to assess the impact of regulation of this profession. It is important that we take the time to consider all relevant perspectives and to analyze potential impacts on the health care system, service providers, Indigenous communities and the public.
I appreciate that there is extensive support for the regulation of counselling therapists in Alberta. I ask for your patience as we undertake the additional consultations and analyses that we believe are necessary to support any decision by government about the regulation of counseling therapists in Alberta.
The psychologist profession is also regulated under the HPA within the College of Alberta Psychologists. The HPA protects certain titles for the purpose of transparency and public accountability, within the context of the provision of health services. These protected titles are set out in the HPA and relevant profession regulation to ensure only skilled and competent regulated members of a college can use these protected titles to provide safe and ethical care to Albertans.
This makes it easier for the public to identify regulated health professionals and, if necessary, to contact their regulatory colleges. This also ensures only regulated health professionals can use these protected titles. The Government of Alberta does not promote or advocate for including any protected titles with a college or an association for any profession.
Rural mental health in general — specifically, improving mental health supports for farming families in rural communities — is a priority for Alberta’s government. Wesupport a number of programs, services, and resources for Albertans living in rural areas, including the expansion of Alberta 211, which provides information, referrals and crisis support via phone, text, chat, and website, including virtual and local mental health and addiction referrals and resources. Alberta’s government is also providing $6.75 million in funding over two years to Counselling Alberta to provide both in-person and virtual mental health counselling services across Alberta.
Alberta Mental Health and Addiction provides grant funding to the Canadian Mental Health Association (CMHA) for the Rural Mental Health Project. Through this project, CMHA works with rural communities across Alberta to develop and implement local action plans to increase mental health awareness and improve overall mental health. Animators in each community are trained to lead a community engagement process to identify their unique local assets and challenges and develop a road map to improve mental health in their community. Between April 2021 and March 2022, the Rural Mental Health Network hosted 21 workshops and information sessions that were attended by more than 900 individuals. To date, community grants have been awarded to 55 projects for initiatives supporting support 66 communities through this project.
As the agency responsible for the delivery of health services in the province, AHS offers a number of phone, virtual, and in-person mental health services across Alberta, including community addiction and mental health clinics and a continuum of other programs and services. Albertans can find a complete listing of local mental health and addiction supports on the AHS website. Alberta Health also provides funding to primary care networks (PCNs) across Alberta that offer a variety of supports, including mental health services.
The Department of Health, AHS, Public Safety and Emergency Management, and police partners have been working together to improve police response to mental health calls across the province, including additional supports for rural communities. Supports in development include strategies to assist police in de-escalation and increased safety for all parties, guidance in identifying whether an individual should be conveyed to a designated facility for a mental health assessment, and improved linkages to community-based resources.
As well, Alberta’s government invested $789,000 in 2021 to support system building and early implementation of the HealthIM System, which helps police officers assess the needs of a person experiencing a mental health crisis and then connects them to appropriate supports and services. Budget 2022 provides an additional $1.6 million to continue the provincial rollout of HealthlM. While the Edmonton Police Service was the first to use the HealthIM platform in Alberta in July 2022, the platform has been rolled out to additional police forces in Medicine Hat, Lethbridge, Camrose, and the RCMP K Division Central and will continue to be implemented in most forces across the province over the next year in a phased approach. Alberta’s government will work with police services to determine next steps.
The regional Police and Crisis Team (rPACT) expansion is one of several initiatives to support Alberta law enforcement in responding to mental health calls to reduce the strain on police resources. AHS Provincial Addiction and Mental Health, Justice and Solicitor General, and RCMP Community Policing are collaborating on the development of a three-year phased approach to provide 20 new rPACTs across the province. When the three-phase rPACT project is fully implemented, there will be 24-7 specialized policing services for 111 RCMP detachments and communities across the province.
The second resolved clause in this resolution urges Alberta’s government to work with the Association of Counselling Therapy of Alberta (ACTA) to create a regulatory body responsible for developing, maintaining, and enforcing regulations, standards of practice, and codes of ethics to the public.
In September 2016, a consortium of 26 counselling professional associations, operating as FACT-Alberta, applied to regulate the profession of counselling therapy under the HPA and to protect the title of “counseling therapist” under that Act. This application was subsequently revised to include three professions within a proposed CCTA: counselling therapists, addiction counsellors, and child and youth care counsellors.
In 2018, the HPA was amended through a consequential amendment contained within the Mental Health Services Protection Act. That Act is now in force; however, the HPA amendment has not been proclaimed.
A precondition for the proclamation of the HPA amendment and the establishment of a CCTA was for the ACTA to make the professional regulation and for that regulation to be approved by the Lieutenant Governor in Council. The ACTA, in collaboration with Alberta Health, developed a professional regulation to govern the profession of counselling therapists, addiction counsellors, and child and youth care counsellors, which subsequently underwent further review and analysis by Alberta Health.
Typically, the analysis of a proposed new regulation includes consultations; jurisdictional scans and evidence reviews; development of policy, standards, education and training programs; financial analysis; and legal advice to identify associated risks and benefits with the proposed new regulation.
On January 29, 2021 , Alberta Health circulated a copy of the proposed regulation to various agencies for review and comment. Based on the feedback provided, it was determined that there was broad support for the proposed regulation; however, there were concerns or limited feedback from First Nations and Metis chiefs and the mental health service operators.
Alberta Health, in collaboration with the Ministry of Mental Health and Addiction, is planning to initiate engagement and consultation with First Nations and Metis leadership and mental health service operators to gauge their support for the regulation of counseling therapists, addiction counsellors, and child and youth care counsellors within the CCTA under the HPA.
RMA appreciates the Government of Alberta’s (GOA’s) response to this resolution and the additional mental health supports that have been put into place for rural Alberta. However, the response does not indicate that the GOA will take any advocacy efforts to ensure that provisional psychologists, pyschologists and registered counsellors with the CCPA will be included in the loan forgiveness program, provided that their practices is located in an under-served rural or remote community. Allowing these practitioners to participate in the loan forgiveness program is a key recruitment strategy and is detrimental to the health and well being of rural Albertans.
Further, the response does not indicate that the GOA will work to create a regulatory body with the Association of Counselling Therapy Alberta (ACTA) to protect the public interest. However, the response did mention that they are investigating this as a potential avenue to increase the level of supports available and asked for patience. Although this promise is not an actionable item, the acknowledgement of the creation of a regulatory body as a solution is a step in the right direction. RMA will continue to advocate for the creation of this body and monitor progress on this issue.
RMA will continue to work with ACTA to advocate for the creation of this body and monitor progress on this issue. Given that the resolution has not been addressed or actioned, RMA assigns this resolution the status of Intent Not Met.