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Waiting list increases for counselling service

NIAMH CAHILL

A HSE counselling service for people with mild-to-moderate psychological difficulties has seen a significant increase in the number of people waiting for an appointment since the Covid-19 pandemic emerged.

At the end of March, 18 per cent were waiting more than six months for an appointment with the counselling in primary care (CIPC) service. This increased to 38 per cent at the end of June, new figures show.

The pandemic has resulted in a change in the nature of referrals with the impact of the virus evident in the reasons for referral, which include bereavement, health anxiety, financial stress, relationship difficulties and domestic violence, according to a HSE spokesperson.

A significant factor contributing to the increased waiting time was the impact of restrictions on face-to-face appointments, which were paused in March.

The service remains unable to provide face-to-face appointments “in some areas”. Furthermore, certain staff were redeployed to assist in the response to the pandemic, resulting in a pause in service delivery in some parts of the country. 

“A significant proportion of clients opted to wait for face-to-face counselling rather than avail of counselling by phone or video, despite the longer waiting time,” said the spokesperson.  

When face-to-face services were paused, structured phone counselling and online video counselling was introduced to mitigate the impact of the pause and reduce disruption to clients in counselling.

Challenges providing counselling to individuals who require interpreters and for those unable to avail of phone or video counselling due to lack of access to broadband, no access to a mobile device, or privacy or confidentiality issues have emerged.

A decline in new referrals to the service following the introduction of lockdown measures in March occurred, with monthly referral rates in April and May less than half that for the same period in 2019.

The referral pathway to the service is through GPs and presentations to GP surgeries dropped significantly during the height of the pandemic in April and May. Recent figures for June indicate an increase in referrals towards pre-pandemic levels.

The HSE’s spokesperson explained that “GP visits dropped significantly at the height of the Covid pandemic and this had a knock-on effect on new referrals to CIPC as many people were not accessing their GP”.

Up to the end of June, almost 4,500 patients had been seen by the service this year. Around 4,800 patients were discharged up to the end of June.
The service established in 2013 is delivered by 200 full-time and part-time counsellors nationally.

Usually, patients are seen weekly and offered their second appointment a week after their first, unless the client chooses otherwise. The CIPC’s experience is “in line with international emergency experience, which indicates that as the acute medical crisis passes, the psychosocial impact of the pandemic becomes more apparent”, according to the HSE spokesperson.

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