Mental health services in Ireland offer a multidisciplinary approach, where a number of professionals offer their particular skills in a co-ordinated and complementary way.
• General Practitioner (G.P.)
The G.P is often the first person to seek help from. He/she will assess the problem and may either provide medication and monitor the patient, or may refer the patient to a specialist e.g. psychiatrist, psychologist or counsellor if necessary. The G.P. may be able to recommend a support group for the particular problem.Where others are involved in the patient’s care (e.g. psychiatrist, social worker, family members, etc.) the G.P. may liaise with them in order to provide the best overall care. The psychiatrist is a medical doctor with a specialist qualification in mental health.
A psychiatrist usually works in a psychiatric hospital or unit, or as part of a community care team. Referral to a psychiatrist is normally through a G.P. An emergency 24-hour service is provided by the doctor on duty at the hospital or psychiatric unit.A psychiatrist will assess the person, usually at a hospital out-patient clinic, forms a diagnosis and treats accordingly. This may involve treatment with medication or referral to a member of the mental health team.Admission to hospital, in a small number of cases, may be suggested if the person’s difficulties are severe.
A psychologist is trained in the study of human behaviour and experience. When involved in the area of mental health, the psychologist usually works as a clinical, community or counselling psychologist, and unless also medically qualified, does not prescribe medication.
. Clinical Psychologist
The clinical psychologist has a specialist qualification in mental health and works as part of the mental health team in a unit or hospital and is involved in assessment and counselling therapy. Family therapy may be provided where appropriate, and a particular approach may be used for specific problems, such as a cognitive-behavioural approach for phobias. Referral is often through a G.P or psychiatrist, but self-referral is possible.
The community psychologist has a clinical qualification and works as part of a community based team, with e.g. social workers, speech therapists, community welfare officers etc. The community psychologist is involved in assessing andworking with those with a wide range of problems, including children with behavioural, educational and other difficulties.
A counselling psychologist has a qualification in counselling and often works privately, offering help for a wide range of problems such as relationship difficulties, anxiety, poor self-esteem, etc. Not all counsellors are psychologists.
Some counsellors are qualified psychologists, but many are not. Those who are not may have a basic degree or training in other areas and/or relevant work experience (e.g. teaching, nursing, etc.) plus a counselling qualification. There are many forms of counselling available for a wide range of problems, and many counsellors specialise in particular areas such as addiction, bereavement, etc.All approaches emphasise non-judgemental, attentive listening and respect for the client. Counselling aims to enable people to take control of their own lives, and the counsellor may not adhere to one particular theory.Self-referral is the usual route to counselling, although a GP, psychiatrist or trusted friend may be able to recommend someone suitable. Counselling is often one session per week and tends to be short-term rather than longer-term, although this can vary.
Psychotherapy tends to be more in-depth than counselling. Psychotherapists usually undertake a long post-graduate training which demands that trainees themselves have therapy, often twice per week, for several years.Like counselling, there are many forms of psychotherapy, many of which aim for self-understanding rather than simply the relief of symptoms. Many forms of psychotherapy take account of the unconscious processes which affect us, with some based on the belief that lasting, personal change is not possible without analysis of the unconscious.The techniques and interventions used by the psychotherapist vary according to the theoretical framework within which he or she is working.
• Psychiatric Nurse
The psychiatric nurse plays a central role in the care of the psychiatric patient, both in a hospital setting and in the community. He or she works within a psychiatric service as part of a health care team.The nurse’s activities are varied, depending on the individual needs of the patient. In hospital, the nurse administers prescribed drugs and attends to the patient’s needs on a day to day basis. The community psychiatric nurse usually follows up patients on discharge from hospital, calling to their homes and attending out patient clinics and day care centres.He or she provides a link between community and hospital and between the patient and G.P. Family support is often provided and community psychiatric nurses may also be involved in patients’ rehousing needs.
• Mental Health Social WorkerA mental health social worker is involved in the provision of a direct social work service for patients who are under psychiatric care and for their relatives.The mental health social worker liaises with members of the various services involved in the care of patients (e.g. G.P.s, Public Health Nurses, Community Welfare Officers and voluntary bodies) and also with relatives and employers.The range of possible services provided can include help with accommodation, rehabilitation, social and community skills as well as advocacy work on behalf of mental health patients who may be unable to utilise the various services themselves.
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