In the course of their work counsellors meet with people who may be having difficulty coping with a wide array of life issues - from relationship problems to bereavement, low self-esteem to workplace bullying. Counsellors may also encounter a range of mental health difficulties presenting for clients in the therapy room. This article examines the most prevalent mental health issues in Ireland.

The World Health Organisation defines mental health as: 'a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and  fruitfully, and is able to make a contribution to his or her community'. (HSE, 2008)   They go on to state that mental health refers to more than just 'the absence of disease', but includes 'a state of complete physical, mental and social wellbeing'. (ibid.)

According to Tedstone Doherty et al. (2008) about 12% of the Irish population experiences emotional or psychological distress at any given time and approximately 14% of Irish people reported difficulties with their mental health over a one-year period.

In a 2007 study by the HSE on Irish people’s attitudes towards and awareness of important mental health problems in Irish society, the 1,000 adult participants in the study were asked “What do you consider to be the top three most important mental health problems (or mental health related problems) that we need to tackle in Ireland?” The table below represents the findings:

(HSE, 2007)

It is interesting to compare and contrast the findings above, which indicate what Irish people perceive as the ‘most important’ mental health problems in the country, with data which shows what are actually the most commonly diagnosed mental health issues in Ireland. McDaid (2013) found that “the most common mental health problems cited by GPs as presenting issues were anxiety disorders (49%), depression (24%) and emotional difficulties (20%)” (p.7)

Cross-European research by Alonso, et al. from 2004 found that found that almost one in four people reported experiencing mental health difficulties at some stage in their life, including depression (13.9%), anxiety (13.6%) and alcohol addiction (5.2%)

A 2005 study by Wittchen and Jacobi discovered that 27% of adult Europeans had been affected by at least one mental disorder in the previous 12 months and that the most commonly diagnosed issues were anxiety, depression, and substance addictions.

Kessler et al.  (2005) found that 46.4% of US adult citizens reported being affected by problems with their mental health including anxiety disorder (28.8%), mood disorder (20.8%), impulse-control disorder (24.8%) and substance use disorders (14.6%). In the previous 12-month period prior to this study, 26.2% of the participants had difficulties with their mental health, with anxiety disorders accounting for 18.1% of the issues; mood disorders represented 9.5%; impulse control disorders 8.9%; and substance use disorders 3.8%. (ibid.)

Counsellors are ethically obliged to work within the limitations of their competence. According to the IACP’s Code of ethics: “counsellors recognise the boundaries of their competence and the limitations of their expertise. They provide only those services and use only those techniques for which they are qualified by training and experience. It is an indication of competence that they recognise when they are unable to offer a professional service.” (IACP, 2005, p.4)

With this in mind, I believe that counsellors need to be equipped with knowledge and awareness around severe mental health disorders in order to fully aid some of their clients who may be experiencing such difficulties. Part of recognising our limitations as counsellors may, from time to time, include identifying when our clients are showing some of the symptoms of mental illness and when we may need to enlist the help of - or refer the client to - another professional service.

As we primarily have a duty of care towards our clients, I feel that there’s a need for counsellors to educate themselves as fully as possible around the presenting symptoms of both the common, and not so common, mental health issues faced by the population today. In ensuring this I believe we provide a fully ethical and complete service to our clients.

Donagh Ward
PCI College Lecturer

Donagh Ward is a counsellor based in Waterford city and a faculty lecturer with PCI College.

Donagh will facilitate a workshop for qualified and training counsellors on 'Identifying Common Mental Health Issues in Clients' on the 22nd March in our Dublin West campus, Dublin 22.  Book your place now as places are limited.


References :
Alonso J, Angermeyer MC, Bernert S, et al. (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica.

HSE (2008). Health Status of the Population of Ireland. Retrieved March 3, 2014, from http://www.hse.ie/eng/services/Publications/HealthProtection/Public_Health_/Health_Status_of_the_Population_of_Ireland.pdf

HSE (2007). Mental Health in Ireland: Awareness and Attitudes. Retrieved March 3, 2014, from http://www.healthpromotion.ie/hp-files/docs/HSP00612.pdf

Irish Association for Counselling and Psychotherapy (2005). IACP Code of Ethics and Practice for Counsellors / Psychotherapists. Retrieved March 3, 2014, from http://www.iacp.ie/iacp-code-of-ethics

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. JAMA Psychiatry.

McDaid S. (2013). Mental Health in Primary Care in Ireland: A briefing paper. Retrieved 03/03/14, from http://www.mentalhealthreform.ie/wp-content/uploads/2013/07/Mental-Health-in-Primary-Care-in-Ireland1.pdf

Tedstone Doherty D, Moran R and Kartalova-O’Doherty Y (2008). Psychological distress, mental health problems and use of health services in Ireland. HRB Research Series 5.

Wittchen HU, Jacobi F (2005). Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies. European Neuropsychopharmacology.