Richard Hogan: Why are we still waiting for an overhaul of Camhs?

Richard Hogan. Photograph: Moya Nolan

This time last year, the Mental Health Commission (MHC) published a damning report on the provision of services to vulnerable children and families in Ireland. I wrote about the report and said it was a seminal moment in the history of our State, a moment that could either bring about lasting change for families or just another moment to be swept under the carpet, like the Maskey report before it.

That latter report, published in January 2022, highlighted that 240 young people did not receive adequate care, and that 46 children in south Kerry were harmed in care. Anything come of that? No!

Many people are not much interested in politics, and when families and children are struggling the parents’ attention is not on the political system, but it is the politicians who deliver the care, good or bad.

They are the ones that have the power and the means to make a difference, so that when parents are trying to help their child in crisis, the care they receive will be effective and make a difference in their child’s life. We are talking about life-and-death intervention, and yet nothing seems to have happened since the MHC report.

I don’t believe that our government doesn’t care about children. I believe they do. This question about how we care for children and families in crisis is complicated, but I believe we can solve it.

And we must keep pressure on our government, because I recently spoke at an event held by ‘Families for Reform of Camhs’ and heard the harrowing stories of shambolic care in the midst of mental-health crisis.

Parents delineated their experiences of accessing Camhs. They described how relieved they were to receive a referral, believing they were going to get the help they so desperately needed, only to encounter a chaotic service; constantly being handed to different clinicians, and then having treatment terminated without any aftercare, or follow-up care.

They described leaving Camhs more vulnerable than when they entered it. My eldest daughter was with me and asked, as we walked to the train, ‘Is that what happens when families are in distress?’ I am ashamed of my response, ‘It is, currently’. Families in crisis need reform now, not years down the line.

The MHC outlined 49 recommendations in its report last year. The question we should be asking, as tax payers, parents, clinicians, teachers and as a society, is: Why have those recommendations not been implemented? The MHC were clear that there is a solution, yet nothing has happened.

Last week, the Health (miscellaneous provisions) Act 2024 granted extra regulatory powers to the inspector in HIQA, which is to be lauded, but why couldn’t that miscellaneous act have been used to empower the MHC to implement their 49 recommendations and regulate Camhs so that children would be put at the centre of this process for once? So, families in need right now receive better care and support than families received a month ago.

We either value our children or we don’t.

That might seem like an overly simplistic view, and I have met many ministers over the years who care about children and want to do the best for them, but childhood doesn’t wait while politicians figure out how to bring a bill in to law.

The Mental Health Bill, which went to Cabinet this week, is a significant reworking of the State’s mental-health laws. Again, this is to be lauded.

And proves my belief that we live in a country governed by politicians who care about people.

But again, this bill is 10 years in the making. That’s a childhood.

As I said, childhood doesn’t wait for bills to pass. A whole generation of children has been utterly let down by our State. Utterly forgotten and lost.

There are parents who never received the care they needed to help their child.

That is a terrible sentence to write.

And while this bill is a positive step and a very welcome one, the question I have is, ‘How long will this take to get in to law?’ It is a matter of urgency. Yet, it has taken 10 years to get here.

The summer break is coming up and then what? It will just sit there, while families and their children suffer.

The overhaul of Camhs includes independent regulation and a movement away from a consultant-psychiatrist model to a person-centric approach.

The Minister of State for Mental Health, Mary Butler, said that this bill ‘will further modernise, reform and protect the rights of people with mental health difficulties in the decades ahead’.

As I read that I could not help but think of all the families in decades gone by. Failed by our State. The silent voices, forgotten. But we have a chance to change the experience of future families.

Once again, like last year, when I wrote about the MHC report on Camhs, I am optimistic we can bring the change required to help families and children in distress.

This overhaul is well overdue. But currently, until it is law, it is wishful thinking.