Understanding the Mental Health Care Pathway — Where Psychiatry Fits
Mental health care in Ireland operates across three levels. Understanding where psychiatry fits helps you book the right service and get the right level of care for your specific presentation.
GP Mental Health Consultation — first point of contactAppropriate for initial mental health assessment, safety-netting, care planning, and management of common mental health presentations at GP level. Your GP can refer to psychology or psychiatry where specialist input is needed.
Psychology Specialist Consultation — structured psychological therapyAppropriate for evidence-based psychological therapy — CBT, trauma-focused therapy, EMDR — delivered by a CORU-registered psychologist. Psychological assessment for ADHD, specific learning difficulties, and other conditions.
Psychiatry Specialist Consultation — specialist psychiatric assessment and managementAppropriate for complex mental health presentations requiring specialist diagnostic formulation, management of conditions not adequately controlled at GP level, medication management at specialist level, and presentations where psychiatric expertise is clinically required.
Not sure which level of care is right for you? Start with our GP Mental Health Consultation. Your doctor will assess your presentation and advise on the most appropriate pathway — including whether specialist psychiatric assessment is indicated.
What Remote Psychiatry Covers — And What Requires In-Person Assessment
Remote psychiatric consultation covers a substantial proportion of specialist psychiatric assessment and management — but not all. Being clear about scope ensures you get the right care for your specific presentation.
What this specialist consultation covers:
- Comprehensive psychiatric assessment and diagnostic formulation for presentations appropriate to remote evaluation
- Review and clarification of existing psychiatric diagnoses
- Assessment and management of mood disorders — depression and bipolar disorder at specialist level
- ADHD assessment and management at specialist psychiatric level
- Anxiety disorder assessment and management at specialist level
- Trauma and PTSD assessment and specialist management
- OCD assessment and specialist management
- Medication review and management recommendations at the specialist's professional discretion
- Second opinion on psychiatric diagnosis or management plan
- Transition planning — from inpatient to community, from CAMHS to adult services
- Coordination with GP, psychologist, and other members of the mental health team
What requires in-person assessment:
- First episode psychosis — assessment of psychotic symptoms requires in-person evaluation in virtually all clinical presentations
- Active suicidal ideation with significant risk — requires in-person risk assessment and may require emergency or inpatient intervention
- Acute mania — requires in-person assessment and frequently inpatient management
- Involuntary psychiatric assessment — cannot be conducted remotely under the Mental Health Act 2001
- Mental health conditions where physical examination — neurological assessment, metabolic screening — is required before formulation
Your psychiatrist will advise clearly if your presentation requires in-person assessment and will coordinate the appropriate clinical pathway. Patient safety is always the clinical priority.
Conditions Commonly Assessed and Managed
- Mood Disorders
- Major depressive disorder — including treatment-resistant depression requiring specialist review
- Bipolar disorder — Type I and Type II — management review, mood stabilisation, and specialist medication management
- Persistent depressive disorder — chronic depression requiring specialist assessment
- Cyclothymia — assessment and management
- Perinatal mood disorders — depression and anxiety in pregnancy and postpartum at specialist level
- Seasonal affective disorder requiring specialist input
- Anxiety Disorders at Specialist Level
- Generalised anxiety disorder not responding to first-line management
- Panic disorder with significant functional impairment
- Social anxiety disorder — specialist assessment and management
- Health anxiety — severe presentations requiring specialist input
- Agoraphobia with significant functional impairment
- Specific phobias requiring specialist assessment
- Trauma & PTSD
- Post-traumatic stress disorder — specialist assessment and management
- Complex PTSD — arising from prolonged or repeated trauma
- Dissociative presentations — assessment and management
- Childhood trauma — specialist assessment of adult presentations
- ADHD
- Adult ADHD — psychiatric assessment, diagnostic formulation, and specialist management
- ADHD with comorbid conditions — anxiety, depression, substance use
- Medication initiation and review at specialist psychiatric level
- Transition from CAMHS ADHD management to adult psychiatric services
- OCD & Related Disorders
- Obsessive-compulsive disorder — specialist assessment and management
- Body dysmorphic disorder
- Trichotillomania and excoriation disorder
- Hoarding disorder at specialist level
- Personality Disorders
- Personality disorder assessment and formulation
- Borderline personality disorder — management support and specialist coordination
- Coordination with psychological therapy services for personality disorder treatment
- Neurodevelopmental Conditions
- Autism spectrum disorder — assessment support and management coordination in adults
- Intellectual disability with comorbid mental health presentation
- Neurodevelopmental conditions with complex psychiatric comorbidity
- Other
- Eating disorders — psychiatric assessment and coordination with specialist eating disorder services
- Substance use disorders — psychiatric comorbidity assessment and management
- Sleep disorders with significant psychiatric dimension
- Psychiatric second opinion — independent specialist review of diagnosis or management plan
- Transition planning — from CAMHS to adult services, from inpatient to community
What Your Consultation Includes
Comprehensive Psychiatric AssessmentYour psychiatrist will conduct a thorough psychiatric assessment — covering your presenting concerns, psychiatric history, developmental history, family psychiatric history, medical history, current medications, substance use, risk assessment, and social and occupational functioning. This structured assessment forms the basis of your psychiatric formulation.
Psychiatric FormulationYour psychiatrist will develop a formulation — a specialist clinical explanation of your presentation that integrates biological, psychological, and social factors — providing the framework for your management plan. This is shared with you and, with your consent, with your GP and other members of your care team.
Diagnostic Review and ClarificationFor patients with existing psychiatric diagnoses, your psychiatrist will review the clinical basis of those diagnoses — confirming, refining, or reconsidering them in light of the full assessment. This is particularly valuable for patients who have received diagnoses they do not fully understand or that have not led to effective treatment.
Specialist Management PlanBased on your assessment, your psychiatrist will provide a specialist management plan — including medication review and recommendations at the specialist's professional discretion, psychological therapy recommendations, lifestyle guidance, and a clear follow-up pathway.
Risk AssessmentEvery psychiatric consultation includes a structured risk assessment — covering risk to self and others, protective factors, and safety planning where relevant. This is conducted sensitively and as a standard clinical component of every consultation.
Coordination with Your Care TeamWith your consent, your psychiatrist will communicate with your GP, psychologist, and other members of your mental health care team — ensuring continuity and integration across your care pathway.
Second OpinionFor patients seeking an independent specialist review of a psychiatric diagnosis or management plan — including opinions received from other psychiatrists or in other countries — your psychiatrist will conduct a full assessment and provide a clear, evidence-based independent perspective.
Medication Management in Remote Psychiatry
Medication is frequently a central component of psychiatric management — and medication decisions in psychiatry require careful specialist clinical judgement. Here is how this works in the context of a remote psychiatric consultation:
What is appropriate in a remote psychiatric consultation:
- Review of existing psychiatric medication — assessing efficacy, tolerability, side effects, and appropriateness
- Recommendations for medication adjustment where clinically indicated
- Initiation of medication for conditions appropriate to remote assessment — following thorough clinical evaluation
- Education on medication — mechanism, expected response, side effects, and monitoring requirements
What requires additional consideration:
Controlled medications — including stimulants for ADHD and certain other medications — are subject to additional prescribing requirements in Ireland. Your psychiatrist will advise on the clinical and regulatory pathway for these medications based on your specific presentation
Medication initiation for complex presentations — where the clinical picture requires further assessment before medication decisions are appropriate, your psychiatrist will advise on the necessary next steps
All medication decisions are made solely at the psychiatrist's professional discretion following full clinical assessment. No medication can be initiated or adjusted without a thorough psychiatric evaluation. Your psychiatrist will not prescribe medications that are not clinically appropriate for your presentation.
A Note on the Mental Health Act 2001
The Mental Health Act 2001 governs involuntary psychiatric assessment and admission in Ireland. Remote psychiatric consultations cannot facilitate involuntary assessment or admission — this requires in-person assessment by an approved psychiatrist under the Act.
If your psychiatrist determines during a remote consultation that your presentation may require involuntary intervention, they will advise you immediately and direct you to the appropriate service — which may include attending your nearest emergency department or contacting emergency services.
This limitation is stated clearly because patient safety requires transparency about what remote psychiatric care can and cannot do. If you are in crisis or believe you may need urgent in-person psychiatric assessment, please contact emergency services or attend your nearest emergency department rather than booking a remote consultation.
Support for Expats and International Residents
Accessing specialist psychiatric care as an expat or international resident in Ireland presents specific challenges — long HSE waiting lists, unfamiliarity with the Irish mental health system, language barriers, and the cultural dimension of discussing mental health across different clinical and cultural frameworks.
Our psychiatrists provide consultations in English, Portuguese, Spanish, Czech, and Romanian — and are experienced in the specific challenges facing international communities in Ireland. For expats managing psychiatric conditions that were diagnosed and managed in their home country, our psychiatrists can review existing diagnoses and management plans within the Irish clinical context — ensuring continuity of care across healthcare systems.
Why Patients Choose Us
IMC Specialist Division — PsychiatryOur psychiatrists are registered on the Specialist Division in Psychiatry with the Irish Medical Council — the highest level of psychiatric qualification available in Ireland. You are speaking with a consultant psychiatrist, not a GP with a mental health interest.
Specialist diagnostic formulationA consultant psychiatrist provides a level of diagnostic formulation — integrating biological, psychological, and social factors — that is not available at GP or psychology level. For patients with complex, treatment-resistant, or misunderstood presentations, specialist formulation is clinically transformative.
Same-day and advance appointmentsAvailable seven days a week including evenings and weekends — because mental health crises and significant psychiatric concerns do not follow office hours.
Second opinion expertiseOur psychiatrists regularly provide independent second opinions on psychiatric diagnoses and management plans — including those received from other psychiatrists or in other countries. This is particularly valuable for patients who have received diagnoses they do not understand or management plans that have not produced the expected clinical response.
Integrated care coordinationOur psychiatrists communicate with your GP, psychologist, and other care team members — with your consent — ensuring that your psychiatric care is integrated with your broader mental health and physical health management.
Multi-lingual psychiatric careConsultations available in English, Portuguese, Spanish, Czech, and Romanian — because discussing psychiatric history, trauma, and complex mental health in your first language is a clinical necessity, not a preference.
