CHILDREN MADE TO WAIT A YEAR
Mental health appointments are delayed as experts warn that early detection is vital
VULNERABLE children are being left waiting as long as a year to get their vital first mental health appointment, shocking HSE figures show.
Almost 300 youngsters have had to wait for 12 months or more after being assessed as needing attention. The figures were revealed as experts warned that early detection is crucial in helping the children and teenagers, some of whom are suicidal and some with severe behavioural problems.
Of the 286 waiting for at least 12 months, 105 have experienced delays of over 18 months for their first appointment with the Child and Adolescent Mental Health Services (CAMHS).
Over 2,000 young people are now
on the waiting list, including those waiting less than a year.
The figures were released through a number of Dáil questions by Sinn Féin spokeswoman on health Louise O’Reilly, and they show that staffing levels in CAMHS are currently at just over half (57%) of what they are supposed to be.
Meanwhile, Colman Noctor, child and adolescent psychologist at St Patrick’s Hospital in Dublin, warned that ‘all mental health problems, universally, will benefit from early detection’.
He added: ‘The prognosis improves the earlier any mental health difficulty is detected, but not all mental health problems are mental illnesses.’
He said that primary care is the way to go to make sure that issues can be screened early, detected and treated without the need to escalate to more acute services.
And Deputy O’Reilly said: ‘Every expert in child and adolescent mental health will tell you that early intervention is absolutely vital in avoiding enduring and worsening problems in the future.
‘Yet, these figures reveal nearly 300 children are waiting over a year to access basic services. These waiting periods are simply unacceptable and they put people at very serious risk.’ Deputy
‘Early intervention is absolutely vital’
O’Reilly said that mental health issues are emergency health issues and that you would not expect anyone with a physical health emergency to wait more than a year for treatment.
As of October this year, 2,250 children and teenagers were on the CAMHS waiting lists across all nine of the Ireland’s Community Health Organisation areas.
Cork and Kerry, listed as CHO number four, has the highest demand for mental health services for children and teenagers, with 681 on the waiting lists. The next highest, with 342, is the CHO covering Laois, Offaly, Longford, Westmeath, Louth, and Meath.
In response, the HSE said that as of this October, 79% of referrals nationally were offered an appointment within 12 weeks.
Every effort is made to prioritise urgent referrals so that young people with high-risk presentations are seen as soon as possible, and this can often be within the first 24 to 48 hours, it added. This will impact on waiting times for cases which clinicians consider to be less severe, the HSE said.
It also said that the CAMHS Waiting List Initiative, which is focusing on ensuring that no-one is waiting over 12 months, is continuing despite the challenges caused by the level of vacancies and the difficulty in recruiting. The number on the waiting lists for October is down slightly from the same time two years ago.
In 2006, the Government at the time published a report, called A Vision For Change, from an expert group on mental health policy.
It detailed a comprehensive model for mental health service provision in Ireland.
In 2013, a new HSE Mental Health Directorate was established with the full and operational responsibility for the delivery of A Vision For Change.
However, figures from the HSE show that it is behind on targets set by the A Vision For Change policy. According to a response to a Dáil question released to Ms O’Reilly, staffing levels in CAMHS are currently at 57% of what they are targeted to be under A Vision For Change.
The HSE says there are over 110 vacant full-time, or whole-time equivalent, CAMHS posts across all CHO areas.
On this issue, it said that it is running recruitment campaigns for consultant child and adolescent psychiatrists.
According to the HSE, of all posts advertised in the last two years, only half have been filled, due to lack of applicants or lack of appropriate qualifications for the more specialist posts which require more specialist qualifications, or because candidates refuse the post or withdraw from the recruitment process.
Mr Noctor said staffing and capacity are a major issue for the service and that there is a ‘shortage of psychiatrists within our specialty across the country’. There is also a shortage of specialist psychiatric nurses in all the allied disciplines, he added.
The HSE said that there are a number of responses available for children and young people who present with mild to moderate mental health difficulties.
These responses include primary-level care; the HSE Digital Mental Health Service Improvement
‘All aspects are being improved’
Project; the National Centre for Youth Mental Health, Jigsaw; as well as a computerised cognitive behaviour therapy called eWell for young People aged 12-18 Years, developed by HSE Primary Care. The HSE said it invested almost €10million in Jigsaw services last year.
In response to Ms O’Reilly’s comments, the Department of Health said that developing mental health services remains a priority for the Government, adding that in the recent budget an additional €55million was made available for mental health.
‘All aspects of CAMHS nationally are being improved by the HSE under its annual Service Plans including addressing waiting lists,’ said the Department in a statement. ‘The development of a mental health telephone line, signposting tool and digital online supports for those accessing information about mental health is being developed by [Junior] Minister [Jim] Daly and the HSE to improve access to mental health services.’
It added: ‘The [Health] Minister [Simon Harris] will meet all CHO chief officers and executive clinical directors at the Department of Health in January in an effort to improve service delivery and waiting times nationally.’ Comment – Page 14 ronan.smyth@dailymail.ie
IF we know anything about the health of children, physical or mental, it is that early intervention pays massive dividends. A problem solved now means there are no further complications, and outcomes generally are far better than if the condition is allowed to drift.
Nowhere is this truer than in the area of juvenile mental health, which is why it is utterly inexplicable that children are waiting up to a year for appointments after being referred to psychiatrists.
On New Year’s Day 2015, 11-year-old Milly Tuomey from Dublin attempted to take her own life and, while she was rushed to hospital, she died four days later. She had posted about her suicidality on Instagram and her parents Fiona and Tim sought help that was not forthcoming.
What other evidence do the Government and the HSE need in order to understand that critical intervention saves lives? How can they stand over a service that lets the most vulnerable children slip through the net, leaving a reservoir of grief that never can be drained?
As it stands, 286 children with behavioural problems, or suicidal intentions, have waited more than 12 months for appointments with the Child and Adolescent Mental Health Service while a total of 2,250 children were on the waiting lists. That is scandalous. We are building the world’s most expensive paediatric-care facility in the form of the National Children’s Hospital, while staffing levels in CAMHS across the country are currently at 57% of what is targeted under the Vision for Change programme.
There are over 110 full-time, or wholetime equivalent, CAMHS posts vacant across the country.
Plans for the new hospital look wonderful, and children with physical ailments deserve a nice environment, but, while it must be acknowledged that the HSE is recruiting for those posts, the money being spent on landscaping probably alone would pay for all those vacant positions.
Ill-health is not always visible. For the sake of children who intend to harm themselves, we must redirect resources to ensure they are seen not within 12 months, not within one month, not within one week. They must be seen now.