James Browne (Wexford, Fianna Fail) | Oireachtas source

I want to address the lack of psychologists in our health service. Often when I or other Deputies highlight service gaps in mental health services provision or the fact that CAMHS staffing levels are barely more than half that recommended in A Vision for Change, the response by the Government is to cite difficulties in recruitment as a key cause of the difficulties.

However, some of these difficulties could well be self-inflicted. I am speaking in particular to the recruitment of psychologists by the HSE. There has been an issue with this for a number of years especially related to whether they were clinical or counselling psychologists. In 2009 the HSE established a working group of psychology managers to review recruitment procedures for psychologists. Criteria were developed that clearly favoured clinical psychologists for employment in the HSE. Counselling psychologists were deemed eligible to work with only one care group despite already working in the areas from which they were suddenly deemed ineligible.

As a consequence of this, counselling psychologists were excluded entirely from child and adolescent mental health, CAMH, services between 2009 and June 2016. A review process was conducted resulting in some progress being made with regard to the opening up in principle of HSE posts to psychologists other than clinical psychologists. Ultimately it made some helpful and some unhelpful recommendations. The major concern is the stipulation that psychologists who have completed training programmes that do not map neatly to specific criteria around placements were deemed as ineligible for particular care areas in 2016 and 2017 recruitment campaigns and could potentially never be able to work in the HSE after October 2019.

The effect of the recommendations in the period since the issuing of the report has been that trainee psychologists other than trainee clinical psychologists do not know whether they will be eligible to work in the HSE after they graduate. They may be faced with an effective lifetime ban on working in the HSE if the October 2019 stipulation stands.

After the issuing of the review report in June 2016, the HSE convened an implementation group to look at the issue emerging from the report but it seems its terms of reference were extremely narrow. The report of that group was, as I understand it, issued in June 2017 but remained with the national director and was not released until 22 November 2017 despite repeated requests from multiple interested stakeholders. Trinity College Dublin has sought and is still seeking a response from the HSE about the problems that are being caused for the current doctorate in counselling psychology programme. IMPACT and the Psychological Society of Ireland have made attempts to engage with the HSE but the executive has still not responded.

The exclusionary recruitment practices used by the HSE for psychologists do not exist in other countries, including the United Kingdom. Its practices are also in direct contravention of the recruitment policy of the Psychological Society of Ireland. As long as the HSE continues to make inadequate use of high-quality psychologists because of its demonstrated preference for clinical psychologists only, will we not continue to face what the HSE terms recruitment challenges?

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