Ms Lisa Molloy:

Good afternoon Chairman and members and the delegates from the Irish College of General Practitioners, ICGP. The IACP would like to acknowledge the work of the committee to date and welcomes and supports the increased focus on mental health and well-being. We fully endorse the integration of mental health services into the primary care sector and our accredited counsellors and psychotherapists have a key role to play in ensuring the success of this initiative.

One of the strongest messages to come out of the consultation that fed into A Vision for Change was that people with poor mental health wanted alternatives to medication, including access to counselling and psychotherapy. A Vision for Changefurther highlighted the under-development of our mental health services. One rural survey found that although one in three GP adult attendees presented with psychological distress, just 11% were in receipt of mental health services. According to the HSE, 54% of GPs in the north-east region said they would have preferred to have counselling available at their GP practice. The region identified a gap in availability of counselling, with many GPs reporting that they did not refer patients for counselling because of a lack of relevant counselling services, waiting lists and cost. A Vision for Changerecommends the provision of an integrated, recovery focused care delivered in the community, primarily by multidisciplinary teams. To date there has been slow progress in the implementation of this policy.

In this regard the Irish Association for Counselling and Psychotherapy, IACP, proposes that the State adopt a programme for the treatment of mild to moderate depression broadly modelled on the very successful initiative known as Counselling for Depression, CfD, in Britain. The committee members will have received a separate briefing which sets out the detail of this programme. In summary, this programme trains counsellors to provide a depression specific therapy for individual clients within the National Health Service, NHS. Professor David Murphy who joins us from Nottingham University is an expert in this area and will speak in more detail to the committee about the success of this programme in Britain.

Our UK equivalent, the British Association for Counselling and Psychotherapy, BACP, developed the programme at the request of the NHS following the introduction in Britain of the national improving access to psychological therapies, IAPT programme. This programme aims to make therapy free on the NHS for low-intensity mental illness, where previously medication was almost the only option. The Irish Association for Counselling and Psychotherapy, IACP, is proposing that an initiative similar to counselling for depression, CfD, be developed in Ireland and that the IACP would partner with the HSE in developing a tailor-made solution for the Irish system. The IACP strongly believes that there is a need for greater availability of evidence-based talking therapies for people with common mental health conditions, that are accessible via primary care services and general practice. Our members are ideally placed to deliver such evidence based therapies which will serve to fill a clearly identified gap.

IACP also believes that access to counselling and psychotherapy services should be available on a universal basis to all those in need of such a service. One way to increase accessibility for the generality of the people in Ireland is to make the services more affordable. As an interim measure we request that serious consideration be given to expanding the existing supports which provide tax relief for medical expenses and also the range of health related benefits that are provided for under the PRSI system, and that this be taken into consideration as part of the wider reform of the PRSI system. Reform of the PRSI system to include options such as counselling and psychotherapy would support mental health services as well as physical health services.

I now hand over to Professor David Murphy who will speak about the counselling for depression, CfD, initiative in the United Kingdom.