PSYCHOLOGY FOR ALL
President’s Address delivered at the 44 th Annual Conference of the Psychological Society of Ireland.
A very well known and former member of PSI Council asked me yesterday, “What do PSI and Tralee
have in common now?” “I’m not sure”, I said, and they responded, “The Rose of Tralee is a lesbian and the PSI President is gay!”
My assuming the role of President of a professional body representing psychology would have been unthinkable until very recently. The election of an openly gay person to the role of President of PSI is reflective of the massive social change nationally and internationally. Not too long ago being gay or lesbian was pathologised by our own profession. Being lesbian or gay was considered a mental disorder. It was not until 1993 (when I was 22) that the World Health Organisation’s International
Classification of Diseases (ICD 10) removed homosexuality as a mental disorder. Such classification in
ICD 10 and in DSM provided the rationale and justification to label lesbian women and gay men as sick. Such classifications provided support for hate crimes committed against lesbian women and gay men in Ireland and across the world. Such classifications resulted in abhorrent psychological interventions such as reparative therapy, a practice which I understand is still being carried out today in Ireland.
So for half my life I was classified as mentally disordered because I was gay. What the mental health community said over these decades contributed to a pretty troubled early life for me, and for many others, I’m sure. What psychology says matters. What psychology says has implications for human beings just like me, your brother, your sister, your loved ones. Perhaps more importantly, changes as epitomised by the ICD also warn of the potential we, as a profession, have to pathologise difference.
The potential we have to partake in the oppression of minorities, to provide the ‘scientific’ evidence which has been used to justify practices that are inhumane and cruel.
With this in mind it gives me great pleasure to draw your attention to the recently finalized Lesbian,
Gay & Bisexual People: A Good Practice Guide for Psychologists by the Sexual Diversity & Gender
Issues Special Interest Group (SDGISIG), chaired by Dr Geraldine Moane. These comprehensive, evidence-based guidelines are a real example of what we do well as psychologists. We draw on reliable evidence to reach conclusions. As President I am committed to working with the SDGISIG to advance these guidelines in PSI, just as our sister professional bodies like the American Psychological
Society (APA) and the British Psychological Society (BPS) have done. These guidelines are a wonderful example of how PSI can be proactive. These guidelines are a wonderful example of how

PSI is ensuring it does not, inadvertently, support the oppression and pathologising of vulnerable groups of people by remaining silent.
At this year’s Annual Conference the Equality & Inclusive Practice Award was presented to Irin
McNulty who worked for many years in the Psychology Service for Refugees & Asylum Seekers at St
Brendan’s Hospital, Dublin. This award draws our attention to the tremendous work done in this area by many psychologists over the years who provide services to the most impoverished and most traumatised of the ‘new Irish’. It also highlights the foresight of people like former president Dr Niall
Pender and former Director of Professional Development Dr Joseph Duffy who established the PSI
Policy on Equality & Inclusive Practice. However, the professional body representing many of these fantastic clinicians remains silent about Direct Provision. Direct Provision, as you know, is a very controversial system of dealing with asylum seekers in Ireland. Established in 1999 as an emergency measure, it continues to this day. Direct Provision has been referred to as the Magdalene Laundries of our day, and has seen children born in this country spend their entire lives in a hotel room, never even being able to share a cooked meal with their families. It is hard to describe the psychological damage such a system is causing to thousands of people. This will have impact that will be felt for many generations to come. We have been silent like many other professional bodies about this injustice. This is all the more unacceptable given the very recent and harrowing accounts of the lives destroyed in religious run institutions as documented by the Ryan Report in 2009. When are we going to learn?
Four years ago the then President of PSI, Mary Morrissey, was on RTE Radio 1 talking about the 40
Tips developed and launched to mark PSI’s 40th birthday and was asked by a journalist – “Where has
PSI been for 40 years?” Many of us were and still are struck by this question. Where has PSI been?
Well, let’s think about this as psychologists! From a developmental perspective we have moved through the various life stages of development. And now PSI is entering mid-life, as we are approaching our 45th birthday as a Society. According to Erikson we are in the Generativity vs
Stagnation stage of life and the task at this life stage is about contributing to society, to the human project, about influencing the next generation. The existential questions at this life stage are Does
my life matter? What is my existence about? How do I avoid stagnation and embrace generativity? I understand that PSI’s opportunity for generativity is located in our capacity to contribute to the betterment of the human project. However, how do we as the learned society of psychology in
Ireland avoid stagnation and embark on a life stage marked by generativity? Well, I’ve a few ideas!

I have to remind myself frequently that the society we live in is one we actively design, it is one we actively create. It is not the result of an inevitable evolutionary process. The society we live in is the result of decisions we make, decisions that should say we want a society that cares about our most vulnerable and values human beings simply because they are that – human beings. And who better than psychologists to understand how vulnerability comes about in the first place? Who better than psychologists to know how best to create a flourishing society? Who better than PSI, as the collective voice for such psychologists in Ireland, to contribute to the betterment of the human project? Who better that a learned society whose motto proclaiming the vastness of the human
mind to advance the human project?
Importantly, it takes the diversity of our profession as expressed in education, science and practice to unleash the potential of the vastness of the human mind. It takes this diversity to un-harness the vast potential of the human project. It takes the many SIGs and Divisions within PSI to do this. It is this skill set represented in PSI that can lead the way in advocating for a society where the psychological needs of our citizens are met. Indeed, more than meeting these needs, it is where the capacity of our citizens is actualised, and where the crippling socio-economic inequalities are addressed. It is where we agitate and educate, and tell our policy makers that underinvestment in social capital will never lead to a sustainable economy. Finally, it is where understanding Ireland simply as an economy will result in economic and social ruin.
This life stage is about finding, and taking, our place at the table where the policies are made that shape and influence our lives and the lives of every citizen in this country. I firmly believe it is time for PSI to get actively involved in shaping and influencing the national policies that in turn shape our experience from the cradle to the grave.
I was thinking about this in terms of the bookends of our lives – the cradle and the grave. Currently there are almost no infant mental health services in this country – with the exception of the fantastic innovative service in Mallow started by Catherine Maguire in 2004 – we are decades behind many of our European neighbours. Yet there isn’t a psychologist in this room who would disagree with the importance of the precious first years of our lives. We know from the literature that these precious first years are the most formative. We know that these precious years influence one’s wellbeing throughout the life cycle and indeed the wellbeing of wider society. There is also a robust evidence base that demonstrates that investment in pre-natal and infant mental health services actually saves money. However we as the professional body for psychology in Ireland have remained silent on the

absence of a mental health service for this critical period of the human trajectory. We’ve got to be smart on these issues. We’ve got to get out of the clinic rooms and the labs and assert the positive health economics of early intervention.
The other bookend of this life of ours is our death. Every year, 29,000 people die in Ireland, and as many as 290, 000 are left bereaved. There are so many gaps when it comes to death and dying in
Ireland that result in significant distress for people and their families at the end of life. And many would argue that better planning of end of life care would cost less. The final year of our lives is the most expensive, due to increased hospital admissions and increased care needs. We currently allocate around €73m annually to specialist palliative care – but approximately €1.3bn is spent on end-of-life care in Ireland annually, largely unplanned and uncoordinated spending. This ad hoc approach is unfair to those dying and their families, and results in a kind of ‘postcode lottery’ to access to services at the end of our lives. This simply isn’t good enough. We have 155 hospice beds nationally – we should have 450. We have ONE psychology post in Palliative Care in this country.
ONE. There are many counties, including Kilkenny I understand, where there are no hospice beds at all. This lack of joinedup thinking is dangerous and damaging. It is costly in human and economic terms.
The Report on End of Life and Palliative Care in Ireland, published by the Oireachtas Joint Committee on Health and Children in July 2014, called for the development of a national strategy for palliative and end-of-life and bereavement care in Ireland. I call on Government to set out clear plans to progress this recommendation on palliative care. There is no time to waste – we have only one chance to get good quality end-of-life care right. PSI can help our policy makers to start asking the right questions – starting by shifting the focus from the individual pursuit of happiness to social connectedness. Psychology can help by getting the question right to begin with. We understand, evaluate and contextualise the social inequalities that result in the stark health inequalities and that, dear audience, basically means a much shorter life for people simply because of their income. That’s simply not fair! Psychology has a range of skill-sets that can make the difference here. It is this range of competencies that psychology has that can transform the experience of people as recipients of care in the health service for example.
It is with this in mind that PSI will continue the campaign of informing the health providers of this country what each applied specialism has to offer and how, collectively, we can provide a national comprehensive psychology service, a psychology service for all. We will advance this by presenting a

model of a truly comprehensive psychology service and thus providing the social cohesion to support a strong, stable economy. Building on the work of Council over the last number of years around this issue I would like to establish a working group to identify best international practices concerning applied psychology in health care, and from that develop a proposal to transform psychology services in the HSE. This proposal to transform psychology services in the HSE will serve as our road map for advancing a national comprehensive psychology service. This is going to take time. And progress may feel slow for many, but we’re going to do this right, we’re going to think of the bigger picture. I propose to invite the Minister for Heath to our Conference next year, to discuss this proposal.
The forthcoming inclusion of psychology in the registration body for health and social care professionals, CORU, presents PSI with some challenges – and with many opportunities. As you know the term ‘psychologist’ will become a legally protected term shortly – with registration currently limited to anyone with an undergraduate degree in psychology and evidence of two years practice in the five years prior to registration. PSI has always contended that this standard does not reflect current practice in the profession, where postgraduate training is the benchmark. In reflecting on this potential disconnect it is interesting to note that psychology is the only group in CORU that requires postgraduate training at a minimum in order to work professionally.
As CORU is the statutory body regulating health and social care professionals their role is to set standards they feel protect the public. However PSI’s role is to represent the best of the profession.
I propose that PSI address this situation by adopting the widely recognised term ‘chartered’ (as in chartered accountant, chartered physiotherapist, etc.) and that the various relevant divisions in PSI develop the competencies based mechanisms to award, for example, chartered membership of the
Division of Health Psychology. This will better provide the public with guidance as to the competencies held by members of PSI, perhaps empowering the various divisions of PSI to provide clarity for the public about what each specialism within psychology has to offer. This year I propose we establish a working group to gather views from membership, review international practice, make recommendations and present to Council. I am delighted to say that the tireless work done on the
PSI Strategic Plan and on The Articles and Memorandum of Association will allow us move forward on these issues.
So I return to the question of where PSI has been. Over the last 44 years we have spent time in development. This development only happened because of the countless hours that so many

individuals have given to the Society over that time. PSI began with 17 members. in 1970 and now we have almost 2500 members. We are here today because of the dedication, the vision and the leadership of countless members of PSI over the last 44 years. We are here today because of their not giving up. It is my privilege to build on the enormous work done by PSI over the last 44 years, and more recently to our previous president Dr Margaret O’Rourke and all of Council. These decades of generosity bestow on us a serious responsibility not to waste this opportunity, not to recoil from the next stage in the life cycle of PSI. And one thing is for sure - we will stagnate if we only look inwards.
I am excited to lead the learned society for psychology in Ireland as it embarks on the next phase of life marked by generativity. I am excited to work with PSI in finding and taking its seat at the table where the policy that shapes the lives of our citizens from cradle to grave is decided. Where we can leverage the knowledge of psychology in education, practice and science, to create a society where the most vulnerable are loved, where difference is celebrated, and where the enormous capacity of the human project for creating a compassionate, economically vibrant, inclusive and socially connected society is realised.
This is how PSI will flourish in the future. It will flourish because psychologists want to be part of a professional body that shapes policy; speaks emphatically, compassionately and tenderly; and takes its place confidently at the table with the grown-ups.
Paul D’Alton
PSI President