Report on underfunded state of children’s mental health services welcomed

A Seanad report laying bare the underfunded state of children’s mental health services has been welcomed by support groups who said its recommendations must be implemented.

The Seanad Public Consultation Committee Report on Children’s Mental Health Services found that the increase in mental health problems and in child population had not been matched by an increase in services.

It says that the number of psychiatric beds available for children in crisis was way below the level required and also refers to a “chronic failure by the HSE to recruit psychiatric nurses and consultant child psychiatrists to operate the existing bed complement in Ireland”.

The launch of the report yesterday heard that it not only reflected the serious flaws in children’s mental health services, but also the solutions.

The report, steered by rapporteur, senator Joan Freeman, made a number of recommendations, including extending CAMHS (Child and Adolescent Mental Health Services) out-of-hours services across the country; delivering CAMHS based on community need; and measuring the outcomes.

In his foreword, committee chairman Paul Coghlan says there was a common theme: “If we invest in early intervention, then we will make savings into the future as the number of crisis cases presenting will be reduced.”

The report outlines how total health budget for mental health has decreased from 13% in 1984 to 7.3% in 2004, to the current 6.1% — in “stark contrast” to trends in other western European countries.

“This chronic underfunding is a repeated failure by State agencies to build the necessary capacity to provide adequate mental health services to children and adolescents,” said Ms Freeman.

She pointed out that in one week this summer, one of the four child inpatient units in Ireland for acute mental health problems closed 11 beds, lowering the national bed complement to 48 beds, with “nurse shortages” cited as the reason. This point was later highlighted by the Psychiatric Nurses Association (PNA) in its response to the report.

Ms Freeman referred to recent commitments made by the Government in the area of children’s mental health, including investing an additional €47m in CAMHS over the next five years.

However, this includes a 29-bed CAMHS inpatient unit at the new Children’s Hospital, “but ignores the HSE’s chronic inability to recruit nurses and child psychiatrists to commission these beds,” she said, adding that when it comes to additional funding pledges of €35m in mental health, “the sums don’t add up” and the real figure could be just €15m.

The director of Mental Health Reform, Shari McDaid, said a 24/7 CAMHS and more primary care supports would “ease the strain on the system”, the latter point echoed by the Irish College of General Practitioners.

Ms Freeman said she would invite Minister of State with Responsibility for Mental Health Jim Daly back into the committee to address how the report recommendations could be implemented, and said the HSE would also be asked in to account for money already in the system.

“It is pointless having a conversation regarding additional funding when we don’t know what is happening to existing funding,” she said.

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