Children in Cork failed by mental health service gap

Distressed children do not have guaranteed access to mental health services at two of the country’s busiest emergency departments (EDs) because of a staffing crisis.

Children in Cork failed by mental health service gap

Recruitment difficulties, combined with resignations and staff leave, have badly hit the Child and Adolescent Mental Health Services (CAMHS) covering EDs at Cork University Hospital and the Mercy University Hospital.

The CAMHS team provides assessment and specialist treatment for young people and their families who are experiencing mental health difficulties.

The care is usually delivered through a multidisciplinary team.

However, the Irish Examiner has learned there was no CAMHS service available at the EDs last Monday.

The source said: “There was literally nobody [from CAMHS] to see these kids other than during office hours in a scheduled clinic. Imagine, a 15- or 16-year-old suicidal teenager turns up at one of these EDs, and there is no psychiatrist to see them.”

The HSE admitted it is experiencing “significant shortages” in CAMHS medical personnel, with vacancies at both non-consultant hospital doctor (or junior doctor) and consultant level.

There are three consultant psychiatrist vacancies and two registrar vacancies in CAMHS services across Cork and Kerry.

CAMHS multidisciplinary teams, which include psychologists, occupational therapists and psychologists, in Cork are operating with less than half the staff members required.

In Kerry, no teams are fully staffed. The HSE said staffing levels range from 55% to 73% of recommended levels under the ‘Vision For Change’ blueprint for mental health services.

“Strenuous efforts are being made to fill the vacancies in Cork, including repeated advertising of the position nationally and internationally and the use of recruitment agencies in the UK and Ireland,” the HSE spokesperson said.

The HSE has sought to plug the recruitment gaps with locum cover. However, it said recruitment is extremely difficult because of a shortage of consultants generally across Europe.

The HSE said the recruitment difficulties have affected the CAMHS service in Cork, particularly since the start of the year.

“Since January 2017, it has been particularly difficult to maintain the NCHD on-call rota to the two Cork city EDs due to a combination of vacancies, sick leave and other factors,” a spokesperson said.

“Notwithstanding that, up to one week ago all efforts were made to ensure that an on-call service was available on a daily basis.”

However, further resignations and sick leave have compounded the service difficulties and the HSE said since March 25, it has not been possible “to guarantee as responsive a service” to the EDs as it would like.

Advocacy coalition Mental Health Reform’s Shari McDaid said: “[CAMHS are] in crisis across the country in terms of being able to get adequate, skilled staff.

"This recruitment problem has been going on for years and the Government needs to have a radical rethink about how it can attract highly skilled specialist staff into CAMHS to ensure there is support in place in a mental health emergency, as well as putting in place the early intervention services in primary care that would prevent severe mental health difficulties from arising in the first place.”

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