A Dublin clinic which aims to prevent full-blown mental health crises by providing early intervention at affordable prices plans to open similar centres in Cork and Limerick, writes EOIN BURKE KENNEDY
IT’S AN irony not lost on those working in the sector. Mental health services are most lacking in the very places they’re most needed. As one expert recently put it, “the system is weakest where it’s meant to be strongest”.
It’s now the perceived wisdom to treat common psychological problems, such as addiction, anxiety or mild depression, with talk therapies at a primary care level, and not, as in the past, with specific medical intervention or hospital-based care.
Yet access to basic, affordable counselling and psychotherapy services through the State apparatus remains limited at best.
While the Government’s strategy to modernise the system clearly identifies the problem, its plan to shift care from antiquated institutions to multi-disciplinary community-based centres has been painstakingly slow.
One man attempting to bridge the gap is psychologist Krystian Fikert, who operates what can best be described as a walk-in high street clinic for a range of basic psychological services.
His MyMind centre in Dublin’s Ranelagh provides clients with swift access to a team of counsellors, psychotherapists and psychologists.
It’s a model of community care that’s being developed in other jurisdictions, most notably in Australia where suicide rates have been cut by 50 per cent in less than a decade.
“At the moment we have public services which are quite complicated to access and which often involve long waiting lists,” says Fikert.
One of the key objectives, he says, was to establish a clinic that could treat people within a short space of time. The aim is to see all clients within 48 hours of contact.
Limited resources can mean State services operate on a triage basis, determining the priority of patients’ treatments based on the severity of symptoms.
“You need to be in absolute crisis before the system steps in because they don’t have enough resources earlier on.”
Fikert’s typical clients are, however, not those with particularly severe mental health problems. They tend to be people with basic psychological issues, such as anxiety disorders or mild to moderate depression.
“They may be having problems in their relationships or experiencing a stressful situation at work.”
The key to managing many of these issues and to preventing them from becoming full-blown crises is “early intervention”, he says. “The vast majority simply need someone to talk to . . . to get things into perspective.”
Many people looking to get treatment for a mental health issue will go to their GP, who will refer them to a specialist, if appropriate.
“Our system cuts out the referring process,” says Fikert, though he’s quick to point out that the clinic is receiving an increasing number of referrals from GPs.
The MyMind centre also addresses what, for many, is the biggest barrier to accessing services, namely cost.
The cost of private counselling or psychotherapy services, usually in the region of €70-€80 an hour, is simply prohibitive for many people in these straitened times.
When it comes to fees, the centre operates a sliding scale based on a client’s ability to pay.
So unemployed patients, provided they produce social welfare certificates, can avail of sessions free of charge, while medical card holders pay only €20 per session.
Even the standard rates, Fikert claims, are 50 per cent lower than average. “Ability to pay should not be a barrier to accessing counselling or psychotherapy services.”
There’s no doubting that Fikert is a man on a mission. But just how did a Polish psychologist find his way to the coalface of Irish mental services?
Having completed an MA in clinical psychology at Poland’s well-regarded Adam Mickiewicz University in Poznan in 2004, Fikert moved to Ireland, initially taking a job with Google in Dublin as a product strategist.
Tasked with finding innovative ways of tapping into the Polish market, Fikert found himself following activity on some of the online community forums set up by Polish immigrants here.
He noticed Polish people were frequently reporting difficulties in accessing mental health services.
To address the problem, Fikert opened his MyMind clinic on Gardiner Street in Dublin in 2006, operating it only on Sundays as he held down his job with Google.
He admits he initially set up the clinic to serve the mental health needs of Poles living in Ireland.
However, demand from the wider community convinced Fikert his approach had a wider application and could be used to fill “gaps” in Irish community health services.
In 2008, he quit his job with Google and went full-time, moving his operation to bigger premises in Ranelagh, and bringing on board a larger team of psychologists and therapists.
The demand for his services led to the establishment of a second centre in Dublin and plans are already under way to open similar centres in Cork and Limerick.
The MyMind organisation also operates online psychological services via Skype for people unable to attend its clinics.
While Fikert is keen to emphasise that online mental health support serves only as a point of contact and in no way seeks to replace face-to-face contact with a therapist, it does attest to his determination to bring services out into the community.
In October last year, Fikert was awarded the Cathal Ryan Scholarship for social entrepreneurship, a €25,000 bursary administered annually by the philanthropic entity, the One Foundation.
Director of Headstrong, the National Centre for Youth Mental Health and columnist with this supplement, Dr Tony Bates, believes clinics such as Fikert’s are what’s sorely lacking in the sector.
“Part of the problem in this country is that for the longest time people have had one of two options when it came to their mental health,” he says.
“On the one hand, you are either perfectly fine and need no one, or on the other hand, you are sent to a psychiatric hospital for specialist treatment.
“Specialist services are important for people with severe mental health difficulties and we most certainly need them.
“But the vast majority of us live somewhere between these two extremes and we all experience some time in our lives when we need psychological support to help us through a difficult time.
“If this is available, we have the chance to grow and mature psychologically through a crisis; and not allow it become a life-long affliction.”
mymind.org
