Poor out-of-hours services fail vulnerable adolescents

A LACK of out-of-hours services means that some young people who might simply need a social worker are ending up in adult psychiatric units, a report has found.

This unfairly labels young people and may potentially lead to stigmatisation and discrimination.

Commissioned by the Mental Health Commission to explain why young people are being admitted to adult units and paediatric wards, the report also finds that deadlines to treat 16 and 17-year-olds by child and adolescent mental health services (CAMHS) are “ambitious” and “unlikely to be met”.

It also says the formal use of paediatric beds to care for children with mental illness — which is happening in Limerick — is risky, even with support from mental health services, as nursing staff seldom have mental health training and are unaccustomed to the use of psychotropic medication.

Written by Scottish consultant child and adolescent psychiatrist Dr Sally Bonnar, the report says this country’s lack of out-of-hours social services means work that in other jurisdictions would be undertaken by social services is falling to CAMHS.

“These cases are often high risk and highly anxiety-provoking and it is difficult to resist the pressure to admit. In many other areas they would be considered “social admissions”, more appropriately dealt with by social services,” Dr Bonnar says.

As highlighted in yesterday’s Irish Examiner, young people do not receive the care they need in adult units and the practice is set to be phased out by the end of next year.

However, this report says it is “difficult to see” how the deadlines for admission of young people can be implemented without considerable development of community teams.

Although there has been significant investment in staff, and new teams have been set up, recruitment has not been easy and the numbers working in CAMHS still do not come near to those recommended by Vision for Change.

The Mental Health Commission said the recommendations form a solid basis for discussion on how best to deliver psychiatric services to children and adolescents.