Mental health teams figure ‘misleading’

IT is “misleading” to say there are 55 child and adolescent mental health teams operating around the country, according to a leading child psychiatrist.

Dr Keith Holmes, chair of the faculty of Child and Adolescent Psychiatry at the Irish College of Psychiatry warned that while it was technically true to say there are 55 teams in place, he warned of mistaking the number of consultants with the number of properly staffed mental health teams.

According to the HSE’s definition, a team is made up of just one consultant.

However a team, ideally, should include a psychologist, a social worker, a nurse, a registrar and an occupational therapist under the clinical direction of a consultant child psychiatrist.

Dr Holmes said new teams often consisted of one consultant with no staff.

According to the Government’s blueprint for improving mental health services, A Vision for Change, there should be 99 community teams for children suffering mental illnesses.

Karol Balfe, Amnesty International Ireland’s mental health campaign coordinator, said the delivery of new child and adolescent community mental health teams was “painfully slow”.

“Although there has been some progress, only 55 of the 99 recommended teams have been established. And those that do exist are running on just a third of the recommended staffing levels, on average,” she said.

For example in the Cavan/Monaghan region, a consultant psychiatrist in the region wrote that due to the impact of “serious under-resourcing” of other child care services, for example for children with autism, her own team was seeing an increasing number of inappropriate referrals with which it could not cope.

In Cavan/Monaghan there are 10.1 WTE (whole time equivalent) clinical staff. A Vision for Change recommends there should be two teams with a complement of 8.5 WTE for such a population.

Similarly, two clinical psychology posts have been filled in the HSE’s Carlow/Kilkenny child and adolescent mental health services, but the HSE is still recruiting two clinical nurse specialist posts to allow the teams to operate.

Teams also face problems with accommodation, with many in inadequate shared and outdated premises.

For example, the Mater/Swords team work in split premises, one in a shared health centre and the other in a rented shared building with a TDs’ office, property consultant and insurance company.

According to documents seen by the Irish Examiner the building is inadequate due to lack of space, location, security, parking and layout. The document states that a proposal to move to suitable accommodation has not materialised despite space being reserved – it seems to be a block at local level and the team continues to work in split premises.

“This is utterly unsuitable and prevents efficient use of available resources,” it says.

At the end of September, HSE figures show, there were more than 2,600 children and adolescents on a waiting list for mental health services – with more than a quarter of them waiting to access services for more than one year.

* If you have a story regarding child and adolescent mental health services contact Jennifer Hough on 021 4802263 or


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