Around half of GPs in some parts of Northern Ireland do not provide in-house counselling services for their patients.
Mental health rights campaigners are calling on Health Minister Robin Swann to ensure everyone has access to the service from their ‘first port of call’ for health issues.
The stark regional differences were uncovered from official data following a freedom of information request by Participation and the Practice of Rights.
The information showed that while on average, 69% of all practices offered in-house counselling as of September 2020, just 51% in the Southern Trust did as opposed to 89% of practices in the Northern Trust.
In West Tyrone just 40% of practices had in-house counsellors, while in East Antrim, they all did.
Other constituencies performing particularly poorly include South Down (45%), West Belfast (50%) and Newry and Armagh (57%).
Sara Boyce, Mental Health Campaign Organiser at PPR, said: “We know that this pandemic is having a big effect on our mental health and will continue to do so for some considerable time.
“GPs will have a key role in connecting people to the support they need, so it’s vital that they are properly equipped to do this.
“Counselling is one effective treatment but at present accessing counselling through your GP practice is a post-code lottery. In some areas every GP practice offers this service but in others, less than half of GP practices can offer it. This cannot be fair or right.”
The charity has launched an interactive map showing the huge disparities in access to inhouse counselling at GPs across NI.
They say GPs, who are traditionally the first port of call for those concerned about their mental health, have reported a significant increase in calls related to mental health as a result of the pandemic.
For many, counselling can offer an effective, low cost form of treatment that can help address pain and distress before it becomes acute while it has been shown to prevent the medicalisation of emotional distress, a key consideration in a post-conflict society with record rates of prescribing for antidepressants.
Speaking on behalf of PPR’s #123GP campaign Mid Ulster activist, Olivia, said: “Just knowing that your GP practice provides a qualified, experienced and appropriately paid counsellor has a cathartic effect in itself, that someone is there if and when needed, instead of having to join the never-ending waiting list for ‘experts’.”
The #123GP campaign is calling on Minister Swann to include a number of commitments in the 10-year Mental Health Strategy.
They include ensuring all GP practices are adequately resourced to provide timely access to counselling, that nobody waits longer than 28 days for a routine appointment and no longer than two days for an urgent one.
They would also see people provided with options for accessing counselling – in their local GP practice or through the Talking Therapy Hubs run by the Trusts.
Additional barriers to accessing counselling identified by the #123GP campaign include waiting times, lack of waiting time targets, a cap of six sessions and inadequate funding.
Alan Stout, chair of the BMA’s Northern Ireland general practitioners committee, said: “Counselling services, and indeed community mental health services, are really important to all practices.
“To date they have been commissioned as a local enhanced service which tends to allow only for temporary contracts and arrangements and can be increased or decreased within the year.
“Most practices avail of this service but some have difficulty accessing a suitable counsellor.
“This highlights the need to create a much more robust and sustainable model where the community mental health worker role and time can be increased in the primary and community care setting where it is so valuable.
“The Multi-disciplinary team (MDT) project has started to address this, but needs extended as a matter of urgency. We are also keen to see the teams embedded in the community to ease access for the population and not create an artificial barrier of having to see your GP before accessing them.”
While Trust-run Primary Care Talking Therapy Hubs offer GP practices another route to refer patients to counselling, PPR say the Department of Health has acknowledged these services are unavailable in significant parts of the population.
A DoH spokesperson said “it is accepted that the Covid-19 pandemic is having a negative impact on mental wellbeing” in Northern Ireland and that they expect the increased “low levels of depression and anxiety will increase further”.
While they have provided additional support through free online Stress Control classes, an apps library and increasing psychological first aid training for health staff, they added: “There is a recognised need to improve mental health service provisions.”
Their latest steps include appointing Prof Siobhan O’Neill as interim Mental Health Champion in June and approving a new perinatal health service.
“A public consultation of the new 10 year Mental Health Strategy was launched on 21 December and runs until 26 March,” they added.
“Part of the vision for the Strategy is to ensure people get the care and treatment they need, when they need it. This includes counselling where appropriate.”
The said the “draft Strategy seeks to shift the focus in mental health towards primary care” as patient outcomes are often better if treatment is provided locally.
“This will increase the roles of GPs and will include easy access to counselling, psychological therapies, specialist interventions and other care and treatment options.”
Professor Siobhan O’Neill, Interim Mental Health Champion said: “People with lived experience of mental illness tell me regularly that counselling is what they want.
“As we implement the mental health strategy, counselling services and psychological therapies must be prioritised and funded appropriately.
“The first place that many people go to seek help for mental health difficulties is their GP.
“The provision of mental health practitioners in GPs practices has been an important step forward in mental health provision here.
“We now need to ensure that these workers are available as part of multidisciplinary teams in all GP practices so everyone in Northern Ireland can access mental health support and counselling if they require it.
“I would encourage everyone to respond to the consultation on the draft mental health strategy consultation, and tell us about which actions we should prioritise, so that together we can shape mental health services here. The strategy consultation remains open until 26th March and is available at https://www.health-ni.gov.uk/mentalhealthstrategy.”
For mental health help and support contact you can contact your GP or Lifeline on 18001 0808 808 8000. In emergencies always call 999.
-- to www.belfastlive.co.uk