A psychologist, referred to as Louise, transitioned from seeking public health roles to accepting a lucrative subcontracting opportunity offering $125 per hour for teleconsultation services. Despite the appealing pay compared to public sector wages, this shift raises concerns about the reliance on subcontracting in mental health services amid significant demand. The CISSS of Montérégie-Centre began these contracts to address pandemic-related waitlists, but the Coalition of Psychologists highlights job reductions within the public network, stressing the critical need for mental health professionals.
Psychologist’s Journey: From Public Network to Subcontracting
A psychologist pursuing a role within the public health system found herself presented with a subcontracting opportunity instead. This contract, offering a remarkable pay rate of $125 per hour, allows her to treat patients through teleconsultation.
Louise, a pseudonym for confidentiality, has applied for numerous roles within the healthcare network over the past few years, yet her efforts have not yielded success.
The Shift to Subcontracting in Mental Health
In her region, the demand for mental health professionals is significant, as Louise shared her experience anonymously to protect her career. Recently, the CISSS of Montérégie-Centre, located at a considerable distance from her residence, reached out with an attractive offer: a remote position with a rate of $125 per hour, allowing her the flexibility to select her clientele.
“They didn’t ask me any questions, except for my license number. There was no interview. In fact, I was sold the position,” Louise reflects on her experience.
In contrast, a public sector role would have provided her with an approximate hourly wage of $40. Even when factoring in social benefits and retirement contributions, the rate she is offered appears appealing.
While Louise expresses a preference for a stable position, she acknowledges that she may come to appreciate her current working conditions.
This subcontracting arrangement bears similarities to those used by staffing agencies, which the healthcare network is attempting to move away from, particularly concerning nurses and caregivers. However, a key distinction is that psychologists are directly hired under contract by the employer.
The CISSS of Montérégie-Centre explained that the acquisition of mental health services was initiated by the Ministry of Health in response to the pandemic, aiming to enhance the network’s ability to address waiting lists swiftly. “Psychologists and therapists provide teleconsultation services that complement existing regular services,” the CISSS stated.
The contracts for these professionals are set to conclude in March 2026, and the CISSS assures that “no positions for psychologists and mental health professionals have been cut.”
However, this reliance on subcontracting raises concerns among the Coalition of Psychologists in the Quebec public network. Since the implementation of Santé Québec’s directive to reduce $1.5 billion from the system, the coalition has noted approximately ten job reductions among psychologists, both for vacant and occupied roles.
“And that’s only those for which we were contacted,” highlighted Dr. Karine Gauthier, the coalition’s president.
According to their professional order, last year only 20% of psychologists were employed within the health network, compared to 47% in the private sector, with the remainder engaged in teaching or supervisory roles. Dr. Gauthier emphasizes, “the needs are immense,” particularly for youth struggling with eating disorders or patients confronting cancer diagnoses.
A psychologist from Montérégie reached out to express her surprise at a contract being extended to a colleague from another region, especially since she has recently seen her own hours reduced and is on the lookout for employment on the South Shore of Montreal.
This situation is particularly perplexing given that the government had previously provided her with a retention grant to support her studies in the field. “And now there is absolutely nothing left in mental health in my area,” she lamented.