Dáil debates

Tuesday, 11 May 2010

 

Mental Health Services

8:00 am

Photo of Dan NevilleDan Neville (Limerick West, Fine Gael)

I thank the Ceann Comhairle for letting me raise again the issue of regulation of the professions of psychotherapy and counselling. At present, they are not regulated. There is no criteria by which one may gauge the standard of psychotherapy and counselling services. Anybody can set up a counselling or psychotherapy service without qualifications and charge a fee to vulnerable people whose lives may be in danger from suicide.

I will give two examples of short courses that allow, facilitate or encourage people to do that. The first is a course to gain a diploma in skills for counselling eating disorders, which is granted to people after fewer than 50 hours' tuition. One could do eight modules over eight weekends and obtain a diploma in counselling for eating disorders. There is no basic qualification required to enter this course. Eating disorders are extremely complex and have emotional, psychological, psychiatric and physical health implications. They have the highest mortality rate of any mental health condition. A counsellor with training of less than 50 hours does not have the range of skills to even understand the issues involved and is not qualified to probe the unconscious. He or she is dealing with human vulnerability and serious damage can de done to very delicate people

The second example I have concerns an advanced diploma in suicide studies that consists of less than 100 hours of tuition. This is marketed as providing people with skills to counsel people at risk of suicide and the bereaved of suicide. Modules include suicide prevention, suicide intervention and suicide postvention, each of which is completed in just two weekends, yet one receives an advanced diploma in suicide studies.

Those who are at risk of suicide, attempted suicide and self-harming require detailed psychiatric diagnosis. This cannot be done with training over three weekends. Some 80% of those who take their lives are suffering from a psychiatric disorder. A bereavement by suicide falls outside the normal range of human experience. It is an overwhelming loss that leaves the bereaved confused and helpless, overwhelmed by many emotions and many unanswered questions.

The two examples show the need to fully regulate the professions of psychotherapy and counselling, which are so essential to dealing with all areas of mental health and emotional difficulties and assisting in many varied areas of counselling, including marriage counselling, family counselling, sex and sexuality counselling, sexual abuse counselling, occupational counselling, bereavement counselling, addiction counselling, long-term illness counselling, and post-traumatic stress counselling. These involve very delicate areas of human vulnerability requiring the highest level of professional assistance. They should be included under the Health and Social Care Professionals Act 2005, which was introduced to regulate 12 professions. The areas to which I refer are not regulated under it because of issues that arose at the time regarding agreement between various groups. Disagreement has now featured for two years.

The psychological forum has criteria setting out the skills required of staff working in these areas. One does not allow doctors and nurses the freedom to walk in and out of each other's profession but it is allowed in respect of psychotherapy and counselling. The forum recommends that the baseline academic qualification for entry to training is a degree or equivalent in human sciences, be it medical, psychological, social or educational. For registration as a psychotherapist, the forum specifies a minimum of four years' training in specific psychotherapy modality at Master's level, which involves 1,400 hours.

With regard to entry for training for counselling, the forum requires that one have a leaving certificate or equivalent qualification, or a relevant degree, while equivalent accredited prior learning is considered. An interview is required to enter training for both counselling and psychotherapy to determine whether one is suitable. The baseline qualification and experience for registration as a counsellor is a minimum of four years' training in specific counselling and psychotherapy modality, involving a minimum of 1,250 hours. This is what is required, not a few weekends of training.

I tabled a parliamentary question asking the professions that have completed registration on the Health and Social Care Professionals Council and the reply stated, "Arrangements for the establishment of the first of these registration boards are currently being finalised". Can I take it that none of the 12 grades has been regulated since 2005 despite the high profile of the Bill which was intended for this purpose? The Minister has informed me that it is not until the 12 grades are dealt with that the areas I am addressing will be considered.

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