Mental health failings ‘are abuse’

Joan Freeman. Photo: Gareth Chaney Collins.

Health bosses have been accused of “abusing” children with mental health issues by neglecting their needs.

Senator Joan Freeman made the accusation at the publication of an excoriating report on mental health care by the Oireachtas committee she chairs.

“I want to say on behalf of the Government I am so sorry to those parents and, in particular, to the children who are actually receiving abuse. Abuse comes in many forms. Neglect is one of them,” she said.

Her criticisms followed publication of a report by the Oireachtas committee on the future of mental health care which details multiple failures in the care of children and adults with mental health issues.

It found chronic staff shortages with staffing levels as low as 47.5% of what was recommended in some regions — depriving people of vital services.

The Child and Adolescent Mental Health Service (CAMHS) had only 56% the number of staff meant to be employed.

In total, there were more than 700 sanctioned new positions unfilled and, on any given day, 600 existing positions vacant. Ms Freeman, founder of suicide prevention charity Pieta House, said the HSE had simply accepted the shortages.

“They shrug their shoulders in a helpless gesture,” she said.

The committee, comprising 21 TDs and senators from all parties and independents, heard from 60 witnesses and studied submissions from 33 patient groups and service providers before producing their unanimous report.

Their 35 recommendations include ending the over-reliance on medication — a treatment route they said was chosen because there were hardly any public counselling or psychology services for GPs to refer patients to for talk therapy.

Out-of-hours services are also flagged as urgently needed to prevent patients turning up at Emergency Departments because there was nowhere else to go when EDs often had no way to care for them either. “Mental health needs cannot be shoe-horned into convenient hours,” the report says.

A review of funding is sought as the proportion of the health budget spent on mental health has fallen from 14% 30 years ago to just 6%.

In tandem with that, the committee wants full accountability for spending after being told by HSE managers their IT system did not enable them to give a breakdown of what was spent on each aspect of mental health.

“When we asked how the CAMHS budget was spent, they said they did not know,” Ms Freeman said. “The HSE offers a smokescreen in order to divert questioning.”

The report is also critical of the Department of Health for repeatedly reviewing services without actually implementing them.

An oversight group appointed by the department is reviewing the ‘Vision for Change’ plan drawn up in 2006 to overhaul mental health services. A quarter of its recommendations have been implemented.

“Securing meaningful engagement proved difficult and continues to prove difficult,” the report says.

Kieran Moore, a consultant psychiatrist who addressed the committee during hearings, told the launch that health managers should be accountable to regulatory bodies in the same way that doctors and nurses could be subject to sanction by the Medical Council and the Nursing and Midwifery Board.

“I have six children at the moment who are all very unwell and I’m speaking to the parents every day and they need to be in-patients in hospital,” said Mr Moore.

We have to look at how we’re structuring the management. The people who make the decisions have never seen a patient in the vast majority of cases.

The ISPCC welcomed the report. The HSE has been asked for its response to the criticisms made.

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