Fiona O'Loughlin (Fianna Fail)
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I appreciate that the Cathaoirleach has selected this important Commencement matter. I raised it last week on the Order of Business and the Cathaoirleach rightly pointed out that I should do so as part of a Commencement debate.

Recently, during a constituency clinic in Newbridge, I met Olive Cross, who heads up a group called Therapists For Change. This is a group of 900 psychotherapists who have come together to work towards improving the mental health service in Ireland and to professionalise the service they are offering. These are very highly skilled and educated practitioners. At present, we have over 8,000 psychotherapists and counsellors qualified, accredited and insured in Ireland, which is a very valuable resource. The issue I raise with the Minister of State, Deputy Rabbitte, is in regard to the registration of these professionals. As it stands, the HSE will not employ someone with a level 8 honours degree in psychotherapy and counselling without them having a second allied health degree, such as social care, speech therapy or nursing.

We all know the number of people who need support with their mental health. However, in many instances, people are using medication and are being prescribed medication when they really need talk therapy, and the underlying issue is not actually being dealt with. It is very important that they have the opportunity to access these professionals.

We are aware of previous issues with rogue psychotherapists. In 2019, the then Minister for Health, Deputy Harris, appointed 13 experts in the field to a new board. This board was tasked with ensuring high standards of professional conduct, education, training and competence among counsellors and psychotherapists. We were told at that stage that the new board would undertake a substantial piece of work before it launched a register. That is obviously something that Therapists For Change is very keen to see established. It was envisaged that this would take up to two years but it is now three years later and we have not heard anything. I want to know where this project is at and when we can expect to see progress.

This is very important. Ensuring that the people of Ireland receive timely, high-quality and impartial counselling and psychotherapy is of paramount importance. A recent report from Jigsaw noted that, in 2021, it had received its highest ever number of referrals and it saw a 104% increase in demand for its online live chat service and a 144% increase in demand for its email support. In February, the HSE’s child and adolescent mental health services, CAMHS, reported a 40% increase. Recent analysis from the Economic and Social Research Institute, ESRI, has shown the impact of Covid, with 40% of young men and 55% of young women classified as depressed, which is very concerning news for all of us. We all know of the waiting lists for people trying to access psychology services.

I have painted the picture. As the Minister of State knows, I could go on with stark statistics in the area of mental health in this country. We have seen failures in the past. We have all lost someone to suicide. We all know someone who has suffered with their mental health. Most of us, if we are to be honest, can say that we have at times suffered with our own mental health. We need to do what we can to ensure people get the services they deserve. The overriding message that I took away from my dealings with Therapists For Change is that they want to be able to help.Its members want to be able, in a regulated and compassionate way, to relieve the pain faced by so many. At the moment, they are being blocked from doing this due to the lack of a central registration process and by burdensome admittance criteria. Psychotherapists have been promised regulation but it has not been delivered. As an addendum to that, students who are looking to go into this area need to see a clear path to how they can receive accreditation to do the work. I appreciate the Minister of State listening and I hope there will be a response on this issue.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Senator O'Loughlin for giving me an opportunity, on behalf of the Minister for Health, to inform the House of the progress made to date on the establishment of the registration board for psychotherapists. The Minister apologises for not being able to come to the Chamber to take the matter.

The Health and Social Care Professionals Act 2005 provides for the protection of the public by promoting high standards of professional conduct, professional education, training and competence through statutory registration of health and social care professions designated under the Act. The legislation is being implemented on a phased basis as registration boards and their registers are being established. Out of the 17 professions designated for regulation, 12 registration boards are currently operating for 15 professions. A profession for regulation is either designated in the Act or can be designated by means of an order made by the Minister for Health under the Act when, following a consultation process, he or she considers it is appropriate and in the public interest that the profession be so designated.

As the Senator will be aware, regulations under SI 170 of 2018 were made by the then Minister for Health, Deputy Harris, in 2018. The effect of those regulations is to designate the professions of counsellor and psychotherapist under the 2005 Act and to establish one registration board for both professions. The Counsellors and Psychotherapists Registration Board was established in November 2018 and its members were duly appointed in February 2019. The board held its inaugural meeting in May 2019 and has held a total of 20 meetings since it was established. Its work includes consideration of the titles to be protected, the minimum qualifications to be required of existing practitioners and the qualifications that will be required for future graduates.

While the Counsellors and Psychotherapists Registration Board has begun working towards regulation of those professions, a substantial body of work requires to be undertaken before a register may be opened. The work of the board is significantly more challenging than it is for registration boards for some of the more established professions, owing to the many different educational pathways into the professions and the variety of specialties and titles used. To date, the board has made progress in a number of areas. This includes the identification, verification and comprehensive assessment of legacy and historical qualifications to determine whether they are appropriate for transitioning existing practitioners onto the respective registers when open. The board has also conducted scoping and research on the regulation of counsellors and psychotherapists internationally. In addition, it has commenced the drafting of separate and distinct standards of proficiency for both counsellors and psychotherapists.

To add my own tuppence worth, I could not agree more with the Senator that young people who are qualifying as psychotherapists and counsellors need clear pathways to professionalism. As Minister of State with responsibility for disability services, I am concerned that parents who seek an assessment of needs from private practitioners are protected. They must be sure the people from whom they seek a service meet the professional criteria. We need a proper register for those practitioners. Far too often, when parents have sought a private assessment of needs, the practitioners are not recognised. This issue is relevant not just in one field but right across the board, including the disability sector. I welcome the Senator's Commencement matter.

Fiona O'Loughlin (Fianna Fail)
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I thank the Minister of State for responding to my Commencement matter. I appreciate that she has outlined the progress made in terms of what the registration board must examine. However, I am concerned that no timeline was mentioned in the response she was given by the Department of Health. The reality is that while we await proper and appropriate accreditation, there is nothing to stop me, her or anybody else with no qualification or training from opening a counselling service tomorrow morning. That is a danger to which members of the are exposed.

As I mentioned, in the absence of the HSE being able to refer people who need counselling and psychotherapy reports, people on waiting lists are accessing medication as a support. Obviously medication has its place but in the majority of cases talk therapy gets to the root of the problem. I honestly believe we have a mental health crisis and not only based on some of the statistics I mentioned. This issue must be a priority for the Government and Minister for Health. I would appreciate if the Minister of State conveyed that message and asked for the coherent and cogent timelines we would expect.

Anne Rabbitte (Galway East, Fianna Fail)
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I trust the Senator will appreciate that, but for the day that is in it, the Minister for Health would be in the Chamber to address this very serious issue. I will inform him that no timelines were outlined and that significant work is required to prevent rogue operators operating in the industry. That is why we need this sector regulated to protect all. I thank the Senator for tabling her Commencement matter.