Monday 9 December 2019

'No regulation means vulnerable people are being put at great risk '

Fine Gael TD, Dan Neville, President of the Irish Association of Suicidology, explains why he wants to see regulation of counselling and psychotherapy services here, to better protect those using these services

A willingness to engage with therapy is vital in overcoming eating disorders. Picture posed. Photo: Getty Images.
A willingness to engage with therapy is vital in overcoming eating disorders. Picture posed. Photo: Getty Images.
Dan Neville is campaigning for regulation of counselling services

Dan Neville

ANYONE can hang a sign outside their door in Ireland and claim to be a counsellor or psychotherapist. It's possible to gain a qualification as a 'counsellor' by completing a course that lasts just a few weekends, and supposedly gives students the skills required to treat those at risk of suicide.

I have been campaigning for the regulation of counselling and psychotherapy for the last decade for one simple reason: the status quo is putting lives at risk.

The very nature of mental ill health means that if a sufferer reaches out, they must feel reassured that the professionals from whom they are seeking help are just that – professional.

Counsellors are accessed by people facing a wide range of problems, such as marriage breakdown, bereavement, alcohol or addiction problems or family difficulties.

The current lack of regulation means those in need of treatment or support are playing Russian roulette with their mental health. Without regulation, there are no agreed qualification standards. So it is possible for anyone to run a course offering a diploma in suicide studies or the treatment of eating disorders, for example, without any need to prove their credentials.

Would you accept treatment for a serious physical ailment from an individual who had gained their medical qualifications after completing a 12 day course? Of course not. So, why should people with suicidal thoughts, eating disorders or other mental health issues be expected to accept such incredibly low standards from those claiming to be offering professional help?

In many cases, mental ill health can be much more complex, more multifaceted and more difficult to treat than physical ill health. We must ensure that those offering help, support or advice to vulnerable people are adequately qualified to do so.

I first raised this issue back in 2005, when the Health and Social Care Professionals Act was published. Under the Act, 12 professions are designated and subject to statutory regulation. They include psychologists, social care workers and physiotherapists. Counsellors and psychotherapists are not listed. This means that not only are these two professions not subject to regulation, there is no fitness to practice structure to which complaints can be made, and the awarding of qualifications for the two roles is not monitored.

This can have very serious consequences. I have been working on this issue with Bodywhys, the eating disorder support group, who are equally concerned about the dangers posed by unregulated and unqualified individuals both running courses and purporting to offer professional services to people in extremely vulnerable situations. The treatment of eating disorders is a highly complex area, involving psychological, emotional, psychiatric and physical difficulties. One particular case has been exposed where a high profile psychotherapist, with no professional accreditation or qualification, was offering diplomas in the treatment of eating disorders.

Bogus qualifications are being handed out to individuals who can then go on and claim to provide legitimate treatment for this very delicate condition. There are no pre-conditions for doing one of these courses. Indeed, my secretary applied to do a similar course a number of years ago, and despite the fact that her background was in administration, she was invited to start the course the following weekend.

When I challenged the then Minister of State, Tim O'Malley, back in 2005, about this dangerous situation, he pointed to the fact that the 12 professions listed under the Health and Social Care Professionals Act had reached a consensus approach on the issue of regulation, but the psychotherapists and counsellors group failed at the time to reach agreement.

As a result, a psychological therapies forum was set up by 22 organisations representing counsellors and psychotherapists. The forum abides by a code of ethics and supports the promotion of high standards of conduct, education and training among its members. But self-regulation isn't enough. And under our common law system, it is possible for anyone to take the title of counsellor or psychotherapist and practice accordingly, without training or competence. Anyone can charge €80 a hour to perform psychotherapy or counselling.

I have been pushing to have this dangerous situation addressed for a decade, and one health minister after the next has failed to act. As a result, patient care is being severely compromised and vulnerable people are being put at risk.

The Minister for Health, James Reilly, has listened to my concerns and has promised to take action. The Minister has informed the Health and Social Care Professionals Council that he intends to regulate the professions of counsellor and psychotherapist. In tandem, the Minister is taking action on qualifications, so academic standards can be applied for the accreditation of courses in counselling and psychotherapy.

This is essential as it will mean those currently offering the services will be assessed and will be required to meet academic standards before they are registered.

Changing attitudes in how we talk about and treat mental illness, and getting the issue the attention it deserves, is a slow process.

I have been involved in raising awareness about suicide and self harm for 25 years. People often ask me why I got involved. Was I bereaved? No, I wasn't. I felt motivated to become involved in suicide awareness because in the early 90s, suicide was being completely ignored. It was a hidden part of our society, never discussed, rarely acknowledged.

I was elected to the Seanad for the first time in 1989. I went along to the Young Fine Gael Conference that year, where a motion was passed by Seamus Mulconry, now the executive director of Philanthropy Ireland, to decriminalise suicide.

I brought the issue back to the Seanad, where debate was resisted and I was advised to steer clear of the subject because it would damage my own reputation and hurt those bereaved by suicide.

Later the following year, I brought a bill before the Seanad on decriminalisation, but the Fianna Fáil-led Government rejected it. I had to make several more attempts before the Government finally decriminalised suicide in 1993. It was a hugely significant step forward, particularly for family members who had been bereaved by suicide.

That was the same year that homosexuality was decriminalised here. Ireland has come a long way, as they say, since then, but we are not quite there yet. The regulation of psychotherapists and counsellors will present further challenges – for example, how to deal with the case of community counsellors, many of whom provide important support, but may not have a qualification.

The primary focus at all times must be on the sufferer, the patient, the vulnerable reaching out for help. This is far too sensitive an area to ignore for any longer.

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