Primary Mental Health Care Part 1: A Critical Review of the Irish System| Stephy Publishers


 


Abstract

Primary mental health care is an evolving system, in need of regular revision and requiring innovative and creative adjustments in order to provide the public with an easily accessible and appropriate level and type of service, based on best practice and evidence. This paper is the first in a series of three exploring primary mental health care. The Irish model of care, ‘Counselling in Primary Care’, is presented as well as a number of short-comings associated with that model. The short-comings include eligibility criteria governing access, limitations of service as well as waiting lists; and the medicalization of service delivery.

Keywords: Mental health, Counselling, Primary care

Introduction Acknowledging the need to update Irish mental health policy and service delivery in 2003, the Department of Health and Children (DoHC) commissioned a national policy framework to guide the modernization of mental health services in Ireland. The framework, detailed in a policy document referred to as “A Vision for Change” (AVFC)1 set forth guidance on the implementation of the new mental health system to be launched and rolled out over the next decade. Central to the need for change in service delivery was the lack of standardized care for people with mental health concerns in Ireland. Emphasis within AVFC was placed on early intervention and coordinated services within the Health Service Executive (HSE). A core element of the policy was the collaboration (or shared-care) between the general practitioner (GP) within primary care and mental health teams within secondary mental health care.2 One role of the GP, therefore, was to act as ‘gatekeeper’ to mental health professionals and specialist services where the GP would ‘...detect and diagnose mental health difficulties and either treat the individual or refer him/her to specialist services’.3

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