Stephanie Regan calls on Minister for Health, Simon Harris and Minister for Finance, Paschal Donohoe to cease charging VAT on Counselling and Psychotherapy nationwide.  This is in essence a “TAX ON MENTAL HEALTH”.

Ms Regan who is a clinical psychotherapist herself and is President of EAPA Ireland states that there are a number of known taxation anomalies that result in higher charges being passed to the public as clinicians are being forced to charge VAT on their sessional work.

This is in essence a Tax on Mental Health and a financial barrier to accessibility and I am asking the Ministers to make the necessary changes in the consideration of taxation for these groupings.

Charging VAT on counselling and psychotherapy is totally inconsistent and irreconcilable with the Government’s stated policies of supporting and promoting access to Mental Health Services.

Historically, counsellors and psychotherapists have filled a critical void in our mental health services, by providing clinical care which was unavailable elsewhere. The public have been driven into private care and taxing these sessions is very wrong and needs to change.

The Present Position

The Government taxation rules provide that it is a requirement for Counsellors and Psychotherapists to charge 13.5% VAT to their clients on their therapy session fees. The Revenue Commissioners’ current justification for this practice is that they deem that counselling and psychotherapy do not qualify as a medical or paramedical health service, a category of practitioners who are not VAT liable.

EU Directives and specifically Article 13(A)(1) of the European Communities Sixth directive, sets out that EU members are required to exempt from VAT the provision of medical care in the exercise of the medical and paramedical professions. It is within the remit of the national governments to interpret and decide which professions fall within the ‘paramedical definition’.

I am suggesting to the Ministers that the Revenue Commissioners are incorrectly interpreting counselling and psychotherapy as a non-qualifying medical / paramedical service and I believe this requires immediate change.

Some discriminatory anomalies:

  • If a psychiatrist or psychologist provides the counselling or psychotherapy session they do not have to charge VAT, but if a counsellor or psychotherapist provides that session they must charge and collect VAT.
  • if you visit a chiropodist for your feet, a dietician for diet advice, a chiropractor for your joints or go to an occupational therapist for a deep tissue massage based on current VAT taxation policy all will be treated as medical professionals carrying out medical services but counselling and psychotherapy will not.
  • Fiscal Neutrality – This principle precludes economic operators who carry on the same business activity from being treated differently as far as the levying of VAT is concerned. In this context whether one is liable for VAT is dependent on the activity being carried out and not on the qualification of the taxpayer or person delivering the service.
  • We know that early intervention works best and that the  individual who wants to avail of private therapeutic intervention is attempting to prevent a mental health struggle become a crisis.
  • We know that the public health system is currently unable to meet demand.  The counselling in Primary Care service, managed by the HSE, has long waiting lists and is only available to those with a Medical Card.
  • The majority of the population are without a Medical Card but those who seek support from a counselling and psychotherapy service are being burdened with this hidden VAT charge.
  • Med 1 Reclaiming tax – counselling and psychotherapy cannot be claimed for personal medical income tax relief and is generally excluded from being claimed against private health insurers operating in Ireland…
  • The VAT tax on counselling and psychotherapy is contrary to Vision for Change 2006 and Government state policy on Mental Health Care.



Stephanie Regan

EAPA Ireland President



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