IRELAND: "Concerns about impaired mental health," Child and Adolescent Mental Health Services Report

Indians Daily 📧: newsindiansdaily@gmail.com January 23, 2023 0

Dublin: An interim report of an independent review of Child and Adolescent Mental Health Services (CAMHS) in Ireland has found that too many children and young people are "lost" in the system. A local CAMHS team had up to 140 "missed" cases.

Many children and adolescents seeking mental health treatment do not receive an appointment for up to two years. And a large proportion of children and adolescents seeking mental health treatment do not receive the follow-up care they need, a new report has found.

Some children and young people who are required to make follow-up appointments through CAMHS - including for reviews of prescriptions or medication monitoring - have not had an appointment for up to two years. In some cases, when people turned 18, there was no planning, discharge or transition to adult services.

Some people received no advice about medication, or were not given follow-up appointments to review prescriptions or monitor medication.

The Mental Health Commission (MHC) has today published an interim report written by Inspector of Mental Health Services, Dr Susan Finnerty. Due to "serious concerns and risks to some patients" identified in four of the five community healthcare organizations (CHO) examined so far, Dr. Finnerty decided. They called for "urgent and targeted action" to address these risks. The review found there were 140 "missed" cases in the CAMHS team in one CHO alone.

Nine CHOs across Ireland provide a wide range of services provided outside the acute hospital system, including primary care, social care, mental health and health and welfare services.

Serious problems with CAMHS services in south Kerry were highlighted in a special report in January 2022. Before that, Dr Finnerty was scheduled to conduct this extensive review. Through her analysis, she also found evidence that some CAMHS teams were not monitoring antipsychotic medication in accordance with international standards (there are currently no Irish national standards).

As a result, some children take the drug without appropriate blood tests and physical monitoring, which is essential when taking this drug. The 'inefficient and unsafe' review identified "significant deficits" in several HSE teams and CHOs.

These include team members working beyond their contracted hours, often without compensation, and evidence of stress and burnout among significant numbers of team members. CAMHS staff members "worked very hard, often with limited resources, to try to provide a good service to the public", the report said. The review also found that "a lack of governance in many places" is "contributing to some inefficient and unsafe CAMHS services through failure to manage risk and failure to employ key staff".

In addition, the review found long waiting lists, unacceptable variations in care, lack of capacity to provide appropriate treatment interventions, lack of emergency CAMHS services, understaffing and lack of ICT systems.

Dr Finnerty made two urgent recommendations to the HSE and Mental Health Minister Mary Butler. The CAMHS report raises serious concerns about the lack of follow-up care for children on medication. An immediate clinical review of open cases in all CAMHS teams, with particular attention to identifying and assessing open cases of children lost to follow-up and physical health monitoring of those taking medication. The Minister for Mental Health should ensure as a matter of priority that CAMHS has immediate control under the Mental Health Act 2001.