AQW 38624/22-27


Ms Paula Bradshaw
Alliance Party
South Belfast


Tabled Date: 20/01/2026
Answered On Date: 16/02/2026
Priority Written: No


Question:
To ask the Minister of Health to detail any care pathway that is in place for patients whose referrals to Primary Care and Talking Therapies services are declined on the basis that their needs exceed the duration or scope of commissioned short-term interventions.


Answer:
Across Northern Ireland, Tier 2 Talking Therapies services provide short term, evidence based psychological interventions for individuals with mild to moderate mental health needs. Referrals whether via GP, self-referral, or community pathways are screened or triaged to determine suitability for Tier 2 intervention. When a referral falls within the scope of Tier 2 services, the individual is offered assessment and/or matched to an appropriate community, voluntary, or statutory provider.
Where a referral exceeds the clinical scope, duration, or intensity of Tier 2 Talking Therapies, established pathways ensure that individuals are directed to the most appropriate higher tier service. These typically include Primary Care Liaison Services, Community Mental Health Teams (CMHTs), Psychological Therapies Services, Trauma Services, or Mental Health Assessment Centres, depending on presenting need. In all cases, onward referral is made with the service user’s consent, and the original referrer is updated to ensure continuity of care.
Tier 3 and higher tier services across the region undertake their own triage or assessment processes. If an individual’s needs exceed the remit of the receiving service, clinical discussion determines the most appropriate alternative pathway, and the referral is redirected accordingly.
If a person’s needs fall outside the scope, duration, or complexity of Tier 2 Talking Therapies, the referral is redirected rather than refused, ensuring the individual is placed on the correct pathway for the level of care required.
Within primary care, the NI Local Enhanced Service (LES) supports access to counselling for adults with mild to moderate depression, delivered by practice-based counsellors using low intensity interventions (e.g., guided self-help informed by CBT principles). Where needs exceed what the LES can safely deliver, GPs refer the individual into the mental health assessment and treatment system through established Trust pathways.