Dr. Aideen Brides:

I agree with the Senator. I have no evidence to support this but I know from being in practice that when people in distress come to me, and often they do need medication but also need talking therapy along with it, they come back to me a couple of weeks later because they have not had access to talking therapy and I have no other option but to increase their prescription. That will happen again a couple of weeks later. I might even find myself adding medications I know the patient does not really need but I do not have the allocated time to go through his or her problem. I do not have the qualification. I am not a psychologist and am not trained in therapies.

Once again, if we refer to the Australian model where there might be an in-house person trained in this discipline, if I was able to refer on this person on the first occasion either with or without medication, it would be much more advantageous to the patient. As Dr. Sadlier referred to earlier, there is a lot of evidence that certainly with moderate depression, it is not just medication or just talking therapies but a combination of both. We are not providing adequate services to our patients. We are simply ignoring half of their treatment because we do not have access to that level of care.

If we think back to something mentioned earlier, that is, the lack of regulation among the talking therapies, for want of a descriptive term, we can see that the people are out there or certainly there are vast numbers of them. I would imagine that a lot of them are of a certain standard so it is just about using them appropriately. It is about making them more accessible.

Yes, e-health is good and some patients can engage in online therapies but really therapies need to be accessible. It is a bit like general practice. We need it on the ground and to be accessible to patients and not something they must travel for. Our counselling and primary care service is based in Navan, which is about an hour and 15 minutes from Monaghan. That is just pointless because people need to be able to access it. Often these are patients with very limited means. We need as few barriers as possible to accessing these services. To answer the Senator's question, I do think there is far more prescribing in general practice than we would ideally like to see happening.