The HSE is rolling out a national 'bibliotherapy' scheme – where patients are prescribed short self-help books.
Can curling up in front of a fire with a good book really be the answer to some mental health problems? That's the thinking behind books on prescription, or bibliotherapy, a scheme that is growing in popularity, in which patients who consult their GP with symptoms of emotional or physical pain could end up leaving with a prescription for the local library instead of the pharmacy.
Its effectiveness has been well established since clinical psychologist Professor Neil Frude launched the first scheme in Cardiff 10 years ago and GPs began prescribing certain approved self-help books to people suffering from mild to moderate mental health problems.
The scheme was piloted by the HSE in Dublin's north inner city in 2007. This month, the HSE launches a full version called 'The Power of Words' covering a wide range of material. The long list of more than 97 titles and a shortlist of 42 books is being circulated to GPs, mental health professionals and libraries.
The books, mostly written by leading psychologists with clinical expertise, present self-help versions of established treatment programmes. All were read and vigorously peer reviewed before they made the final list.
The list covers the gamut of books on the common psychological problems experienced by people, including depression, anxiety, panic, eating difficulties, stress and low self-esteem.
It also includes books for children and families on topics such as parenting, worries, bullying, bereavement, separation and eating issues.
"We did a lot of research to come up with a list of books that have been field tested and that don't just describe a condition but that have some form of intervention, as well," says Elaine Martin, a senior psychologist with the HSE who was behind the initial scheme in 2007.
She references in particular a new 'Introduction to...' series that is included and covers such issues as sensible drinking, coping with sleep problems and stress.
"These are all books with fewer than 50 pages so they won't overwhelm the reader. They offer an understanding of the problem with an accessible introduction to techniques for dealing with it. They are a great starting point for sufferers and carers alike," she said.
The scheme evolved from the simple realisation that the system could not cope with the amount of people in need of some psychological intervention.
At any given time about 10pc of adults are feeling symptoms of depression, anxiety, stress, and other common mental health problems.
Yet despite the fact that there are now more services than ever to offer face-to-face contact with mental health professionals, the percentage of people who get access to mental health professionals is still very small.
"People shouldn't have to wait to see a psychologist face to face. The value in this scheme is in its immediate accessibility.
"Also we have a considerable problem with the overuse of medication. Bibliotherapy may be used as an adjunct; it may be used as an alternative. It's a very flexible form of intervention. People can use it while they are waiting for other forms of intervention or instead of other forms of intervention.
"It doesn't have side-effects or some of those complications that have to be considered with medication," she added.
When the scheme was first piloted in north Dublin seven years ago, the take-up was phenomenal.
In the first year, more than 2,500 books were issued from six inner-city libraries – more than in the entire city of Cardiff. Since then similar initiatives have sprung up throughout the country.
Research carried out at the time highlighted positive feedback from participants, with several describing a sense of empowerment and control – often linked with being free from medication – in confronting their problems.
Manor Street GP Dr Desmond Maguire has been on board from the beginning and has witnessed first hand the benefit of the programme for both him and his patients.
"What appeals to me is that the books are validated by professionals. This gives me the confidence to recommend them because there are so many self-help books around.
"I find it very beneficial in first contact with patients to have something to recommend to them, rather than rushing in, sometimes at their request, with medication and also prior to considering whether they would benefit from special services like counselling or other psychological support.
"These books can give people an understanding about their condition and how to manage it in a way that I could never do in a 10-minute consultation," he said.
Dr Maguire acknowledges that the scheme does not work for everyone.
"Some people are not disposed to reading or often times they feel medication will solve their problems, but for those who accept the offer of a book prescription, the feedback has been good.
"It has happened that I have had some people who have cancelled appointments with counselling services because they have made progress primarily through bibliotherapy," he said.
According to the HSE, it is ideally suited to a person who has a good level of literacy, who is highly motivated to work independently to tackle his or her own problem and who is familiar with the process of following a structured 'recipe' in a book.
The emphasis is on the individual's active involvement and empowerment in recovery instead of or in conjunction with medication to deal with the problem.
The man behind it all, Professor Frude, explains how he saw the need for such a scheme when he realised how few people who were suffering from such conditions as depression and anxiety were able to access treatments.
"There were very few therapists so there was a high need and very little resource available.I thought that there must be some way of delivering the psychological treatment that people needed," he told the Irish Independent.
Each year in Wales there are 30,000 library borrowings of books listed in the scheme, which has been copied not just in Ireland but in parts of New Zealand, Brazil, Denmark and Sweden.
Prof Frude believes its benefits have been enormous.
"You don't have to train doctors, write books or build libraries. The scheme uses the existing infrastructure and the familiar idea of a prescription for treatment.
"It enables GPs to write prescriptions for a powerful and effective psychological treatment for common mental illnesses instead of, or as well as prescriptions for medication," he said.
The full list of books is available on the website www.hse.ie/powerofwords.