Dr. Miriam Kennedy:

I agree with Dr. Plunkett. We have surveyed our members in the past year about their role and what they are doing. We say, "rebranding the shrink is to think outside the square." Many of our consultants want to work in teams with that flexibility. We are happy to get nurses trained up with some medication prescribing or some psychological therapies. We want the leadership there. Sometimes our members feel a little disconnected from management in how that change can be effected. Modern consultants want to work within teams and bring our experience to bear in that way.

The Deputy spoke about the psychological therapies. While we want primary care to do that, I also find in my practice that someone is referred to me who perhaps should have been referred much earlier. It can be a real shock to see people with that kind of illness. We have the ability to work with primary care to provide assessments. There is not an inopportune assessment actually, but we need to be able to have a quick discharge back to the relevant care. Psychologically there are therapies that are very helpful, as the Deputy will know from previous discussions, which have an evidence basis. Some others are just a waste of time; a good friend could do the same thing. A community pulling together after a trauma is much more powerful than a specific psychotherapy in the early stages of trauma.

It is about the evidence-based treatments that we have between primary care and us. It is not always that talking therapies will do the job because they will have side effects if they are not recognising what is needed or indeed if another resource like a community or a housing resource is what the person needs for his or her distress.

The college would be very open to agreeing that the consultant does not have to do everything. We do not want to be photocopying, as well as providing psychotherapy, but we want to be able to assess, liaise and lead, based on the evidence.