What are the mental health services for over-18s? | Jigsaw Online

Mental health services if you're over 18

If you’re feeling down or anxious or just generally not in a good place, there are many mental health services and supports that can help you.

Once you’re 18, you don’t need the consent of a parent or guardian to contact any services, but you can ask for support from them if you think it would help you. 

Below we’ve made a list of the mental health services for young people who are 18 or older. Whichever service you go to can depend on factors like what’s available in your area and what difficulties you’re having. If you talk to a health professional they should guide you on that. 

Your family doctor

Your GP is often the first person people go to. There’s a few reasons to start with the GP: he or she will have your family history and know you, so will be in a good place to advise you on treatment or other services to go to. The other reason is that some services, such as the HSE’s Adult Mental Health Services, require a referral from a GP. 

When you meet your GP, tell them about how you’ve been feeling and any changes in what you’ve been doing. Your GP might ask about your appetite, your sleep, whether you’re feeling down, sad, anxious, or losing interest in things. They may also ask what support you have in your life (family, friends, girlfriend or boyfriend), and whether you’ve thought about suicide or self-harming. This might feel a bit invasive but he or she is just trying to get a rounded picture of what’s going on for you, and trying to determine what type of support you might need. 

They might ask whether you’d like to get a blood test, to check if there are factors like vitamin deficiencies or hormonal changes that are affecting your mood. 

At the end of the consultation, listen to your GP’s opinion and ask what happens next. Take notes and ask where you can find more information if you think that would be helpful. 

If the GP does not seem concerned or doesn’t offer the advice or referral services that you wanted, that can feel deflating. You have the option to get a second opinion or access a mental health service yourself such as those listed below. 

Primary care services

The HSE (and most other health service providers) divide their services into categories: Primary, Secondary and Tertiary care.

Primary care is loosely defined as the group of health professionals that you first make contact with in the care system. Think GPs, student counsellors, community nurses or pharmacists.

Primary care is for adults who are going through ‘mild to moderate’ mental health difficulties.

Services that work with people with ‘mild-moderate’ mental health concerns tend to be ‘brief’ in nature, working with people for a specified time period.  Often, there will only be one health professional involved in providing support to the person.

Your college or school counsellor 

If you’re a student, there will probably be free counselling services at your school or college. The counsellors are there to help students cope with all kinds of issues. These could be around adjusting to college or school, feeling anxious or depressed, relationship problems, bereavement, or feeling lonely and isolated. Sometimes there are waiting lists, but if you feel it’s urgent let them know.

Cost: Almost always free

Jigsaw

Jigsaw Dublin 15Jigsaw offers free mental health support for young people aged 12-25. There are 13 local services around Ireland.

In each local Jigsaw hub there is a team of health professionals who specialise in helping young people by talking to them one-on-one and helping them through their issues. Jigsaw helps thousands of young people every year this way. It is completely free to talk to a Jigsaw Clinician and you don’t need a referral from a doctor.

If you’re 18 or over, you can contact Jigsaw yourself and ask for an appointment. Check you have a local Jigsaw in your area, and then phone or email them. Learn more about accessing Jigsaw services here.

Cost: Free

Counselling in Primary Care (CIPC)

The HSE’s Counselling in Primary Care service is a free for adults with medical cards. It is a short-term counselling service for people with mild to moderate mental health difficulties. You can get up to eight counselling sessions with a qualified counsellor or therapist. Your GP can refer you to the HSE’s Primary Care Psychology Services or you can use the referral form, or call your local primary care office directly.

Cost: Free

HSE National Counselling Service 

The National Counselling Service was set up to provide support to adults who experienced abuse when they were children. The service offers a confidential counselling and psychotherapy service free of charge.  The counsellors and therapists are based around Ireland and are highly qualified and experienced in working with clients who experienced trauma when they were growing up.

To engage the service, call the branch of NCS in your area. The phone numbers are listed here.

Cost: Free

Support for drugs and alcohol 

The HSE runs the website drugs.ie which has information, a helpline (1800 459 459), an email support service helpline@hse.ie and online chat during business hours Monday to Friday. They also have a directory for drug and alcohol services around the country.

Low-cost counselling

low cost counselling

Unfortunately, there are sometimes waiting lists to get counselling services in the HSE. There are plenty of therapists you can see privately but the cost of private counselling sessions can range between €0 and €120 per hour session.  

If you are keen to see a therapist, some places offer low-cost options depending on your income. It is worth talking to your GP about low-cost counselling services in your area.  

Medical cards and GP cards

You might be eligible for a medical card or a GP card depending on your income or the income of your parent or guardian. Some counselling services will provide free or reduced cost services if you have a medical card.

Specialist services

Clonskeagh Hospital

Secondary and tertiary care are services for people with more severe or complex mental health issues. Secondary care includes community and out-patient services, while tertiary includes inpatient care in a dedicated ward. 

These are specialist services for when mental health difficulties are having a major impact on your life. These services are usually led by psychiatrists and will try to understand your mental health difficulties in the context of a diagnosis.   

HSE Adult Mental Health Services

Adult Mental Health Services (AMHS) provide specialist mental health care to working age adults. Most services will have teams made up of psychologists, psychiatrists, mental health nurses and social workers. Some services might have other specialists like addiction counsellors, family therapists and occupational therapists. These professionals work together to offer assessment and treatment based on what’s going on for you.

Everything is free and as it is funded by the HSE.

You might be referred to AMHS by your GP, or health professional if your treatment at primary level didn’t help enough, and/or the issues you have requires specialist services. AMHS helps with issue like moderate to severe depression, anxiety, eating disorders, and self-harm. The treatment they offer can include intensive community-based care, talking therapy, group therapy, medication, and other specialist treatments.

How to refer to AMHS:

You can’t refer yourself to AMHS. A GP or other health professional has to refer you. The GP will decide if what you’re going through is best treated by AMHS so be honest with them about what is going on so they can include detail in the referral letter. 

AMHS tend to prioritise referrals based on how urgently someone needs to be seen. You can call AMHS (or get someone to call for you), explain on the phone you have an emergency referral from your doctor, and they will advise how soon they can see you. Sometimes there are cancellations so they can squeeze you in. 

Cost: Free to those resident in Ireland

AMHS in-patient care

AMHS in-patient care is for people experiencing severe and complex mental health problems, or if there is a strong concern for your safety. Usually a consultant psychiatrist would suggest this if they feel it is the best option to support you towards making a recovery, having tried some other options first.  

Non-profit organisations

Pieta House

There are charities and other organisations that might be able to support you. Many offer free services as they get HSE funding or donations.

Aware

Aware have a support line for anyone who is worried about depression, which operates from 10am to 10pm, seven days a week, as well as a support mail service.

Aware also offer a suite of ‘Wellness @Work’ programmes that are ideal for helping your workplace understand the importance and value of looking after their mental health, and to use relevant coping skills to limit the impact of any challenges or concerns.

Pieta House

Pieta House offers free, one-to-one therapeutic services for people in crisis. If you’re experiencing suicidal ideation, have attempted suicide and or you self-harming, Pieta House have expert counsellors to support you. You don’t need a referral, just contact them for an appointment and they’ll aim to see you within a week. They also offer a 24-hour crisis support and information line on 1800 247 247 staffed by qualified therapists.

Bodywhys

Bodywhys is the Eating Disorders Association of Ireland. They offer online support groups for young people, a helpline, and face-to-face support groups. They also offer useful information on treatment pathways in the public health system for eating disorders, and a four-week support programme for families and parents of those affected by an eating disorder.

Turn2me

Turn2me offers online support groups and online therapy with professionals through video or instant message. The service is free to Irish residents over 18 because they receive funding from the HSE.

Niteline

Niteline is a phone listening service run by and for the students of ITT, ITB, MU, NCAD, NCI, RCSI, TCD and UCD.  You can call them for free on 1800 793 793 and trained volunteer students are there to listen. They are open every night of term between 9pm and 2:30am.

Private health care

Dean Clinic

There are private options for mental health care. Some of these can be covered by health insurance.

If you or your family has health insurance, check what cover offers.

Some employers offer Employee Assistance Programmes, which offer access to counselling support. Check with your manager or HR department to see if your employer offers this.

Sessions with psychologist or a psychotherapist

Sessions with a psychologist or a psychotherapist is sometimes included in an insurance plan. Your insurer might have a list of clinicians that you must chose from, or have a cap on the amount of sessions (such as six). You can find a psychologist through the Psychologist Society of Ireland and a psychotherapist through the ICP.

Private mental health facilities

There are several private mental health care services in Ireland. You will need to talk to your GP if you feel you are in a position to access a private mental health service as they will need to make a referral in the same way as they would for accessing HSE mental health services.