Most mental health problems in Ireland are managed very well at a primary care level. General Practitioners (GPs) are trained in the management of the most common mental health conditions, e.g. anxiety and depression. GPs may have access to other mental health resources at a primary care level such as counsellors and psychologists. A GP (or other doctor) may refer somebody to a psychiatrist for more expert input around the diagnosis and management of their condition.
The public psychiatric services
The public psychiatric services in Ireland are divided up into catchment areas based on a person’s address. Most psychiatrists work as part of multidisciplinary teams (MDT), including mental health nurses, psychologists, social workers and occupational therapists. Mental health services usually consist of outpatient departments, day hospitals, day centres, and inpatient units. The vast majority of mental health problems are managed in the community now rather than in hospital, as this leads to better recovery in most cases.
Referral to a psychiatrist – What happens?
If a GP or another doctor decides to refer you to a psychiatrist (currently the only way to be seen by a psychiatrist in the public psychiatric services), you will usually receive an out-patient appointment for assessment with one or more members of the multidisciplinary team. The initial appointment is often lengthy (1-2 hours) as there is a need to gather a lot of information about your mental health history and your life in general. The reason for this is that mental health problems often are quite complex in origin with contributions from family history, early development and current life stresses. It may also be suggested that a family member accompany you to provide some additional information.
In emergency circumstances an initial assessment may occur in an emergency department or in an assessment unit attached to a mental health centre.
Individual care plan
Following an assessment with a psychiatrist an individual care plan will be developed with you, taking into account your condition, your lifestyle and your personal preferences. The care plan may include lifestyle modifications, psychological therapies, social activities and medications. The psychiatrist’s recommendations with regard to treatment will be based on proven effectiveness from scientific based research. The treatment plan may involve seeing one of the members of the multidisciplinary team over a period of time, a referral to another agency such as a counselling or addiction service or simply advice to your GP in relation to management.