Experts discuss child mental health

The new Mental Health Minister Jim Daly has admitted services for children with mental health difficulties are “not good enough” and that he is “not happy with them”.

Mr Daly made the admission during a Seanad Public Consultation Committee meeting on child mental health services where he said he hoped to bring a proposal to set up an Oireachtas Committee on Mental Health to the Dáil today .

Fianna Fáil has previously proposed the setting up of such a committee.

Mr Daly was asked to rate child mental health services “from one to 10” by Independent Senator Colette Kelleher. “I don’t rate that they are fit for purpose,” Mr Daly said.

Mr Daly’s comments are against a backdrop of multiple bed closures in child and adolescent in-patient units around the country; an ongoing rise in referrals rates to Child and Adolescent Mental Health Services (CAMHS) and 15 “unfillable” psychiatric posts around the country.

The latter was raised by Children’s Ombudsman Dr Niall Muldoon who outlined multiple systems failures with the current CAMHS service. These include “numerous complaints” to his office “about CAMHS team refusing to take referrals from other CAMHS teams when a child moves house” and “numerous complaints” about children being referred by one psychiatrist to an adolescent bed but being sent back “because the residential service psychiatrist disagrees with the referral”.

He said the current services for children were “so far from child-centred” and that he knew of a young girl who was “self-harming under the bed clothes” in a hospital ward, despite one-on-one nursing care.

The question of poor waiting list management was also raised at the committee. Figures earlier this year showed more than 2,500 children awaiting an initial appointment with mental health services, of whom 10% were waiting more than a year. In relation to CAMHS, figures from children’s charity Barnardos found almost 60% had been waiting for more than a year while a quarter have been waiting more than two years for an initial appointment.

Senator Joan Freeman, the Taoiseach’s nominee to the Seanad, said one of those in attendance at yesterday’s hearing was a mother whose daughter developed an eating disorder while on a waiting list. Ms Freeman said she would pursue the issue of waiting lists and make sure the minister stuck to his promise to tackle them.

Tusla, the child and family agency, said it would welcome the implementation of a CAMHS model that ensured timely access to care for children.

Clinical psychologist Dr Eddie Murphy said a “radical rethink” of how services are delivered was needed and she proposed, inter alia, the setting up of Child Centres of Excellence, as a one stop shop/single point of entry, where children with mental health issues and their families would have access to all the relevant health professionals.

Responding to criticism that just 6.1% of the health budget goes towards mental health, Dr Philip Dodd, consultant psychiatrist and HSE National Clinical Advisor & Clinical Group Lead (Mental Health) agreed it was too low, saying research in the British Journal of Psychiatry showed the percentage of investment in mental health is directly linked to health and wellbeing.

Consultant psychiatrist Matt Sadlier, speaking on behalf of the Irish Medical Organisation (IMO), said chronic underfunding “has manifested in a failure of State agencies to build the necessary capacity to provide adequate mental health services to children and adolescents”.

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