Dr. Harry Barry:

I want to add an interesting observation. The IAPT initiative was set up in England on foot of a report that was produced by an economist, Professor Richard Layard, who was asked by the UK authorities to look at the whole area of depression as an illness. I want to clear that up. The report showed that economically, the UK was losing billions in presenteeism and absenteeism as a result of this condition. Professor Layard was sent away to ascertain what the best form of therapy to treat bouts of depression would be. Everybody thought he would recommend that there should be a focus on drug therapy but, interestingly enough, he suggested that cognitive behavioural therapy seemed to stand out as the most effective thing in the long run. As a clinician, I would probably argue that some people who are going through bouts of depression are cognitively incapable of getting involved in counselling or cognitive behavioural therapy. Drug therapy can help some people in such circumstances by allowing their cognition to improve to the point where they can get involved in talk therapy, which is what will really help them to get well. It is important to mention that the UK's decision to pursue this entire approach was an economic one and had nothing to do with the well-being of the people of the UK. It was purely a hard-nosed economic decision. The bottom line is that if we really care about our people and where we spend money, we will have to sit down in a serious and honest fashion. Money is going to have to be assigned and ring-fenced, rather than used as a kind of coin to be thrown in here today and in there tomorrow. It needs to be ring-fenced properly, which requires some kind of organised structure involving groups like the ICP. I do not care how this is done. Surely it must be possible to create a system in which human beings who are in distress are able to talk to somebody. That is all I am asking. As a State, we should provide our citizens with something they desperately need. If it is properly organised and funded, it should not cost the earth. In fact, it might save the State a lot of money.