There is alarm at HSE proposals to move staff from CAMHS and primary care services in one healthcare area to tackle a backlog of assessment of need (AON) cases, with fears that it will leave some vulnerable people short of therapy.
The Irish Examiner has learned that the HSE has contacted psychologists in the HSE CH07 area, covering Kildare and West Wicklow, with a proposal to move between 18 and 20 staff from the Child and Adolescent Mental Health Service (CAMHS) and primary care to tackle a waiting list of around 950 AON cases.
The AON is to allow children to be diagnosed and then apply for resources, but the system has been plagued by problems in recent years. In early 2018, the HSE said it would introduce a new screening process as part of the AON, while a number of families have gone to court seeking judicial reviews, claiming the HSE was not meeting its statutory requirements.
In 2018, professional bodies representing speech-and-language therapists and psychologists said the new Standard Operating Procedure could prove detrimental to children, and may even result in false or incorrect diagnoses. When trade union Forsa intervened, the plans were put on hold — but were finally implemented earlier this year.
It is now understood that up to 20 psychologists from CAMHS and primary care could be moved to tackle the AON backlog for a 12-week period in one area, starting in September. However, one source told the Irish Examiner it was “unrealistic” to expect the AON backlog to be cleared in three months, while patients in CAMHS and elsewhere — some with anorexia or who are self-harming — could be left without adequate psychological support during the secondment.
The source said: “What they are going to do is leave a whole cohort of people who cannot get early intervention, who might deteriorate, and then need more specialist resources.”
They said it is a case of “robbing Peter to pay Paul” and that the idea of clearing the AON backlog in three months “is never going to happen”.
The HSE said Dublin South, Kildare, West Wicklow Community Healthcare is “exploring all options to fulfill our statutory obligation to provide diagnostic assessments to all children who applied for an Assessment of Need prior to January 16, 2020”.
A HSE spokesperson said: “As part of our exploration of options to clear the backlog, a proposal was requested from psychology services across Primary Care, Disability Services and CAMHS in Dublin South, Kildare, West Wicklow Community Healthcare regarding the provision of the relevant psychology expertise for completion of assessments in a 12-week timeframe to ensure this waiting list is cleared to enable children to access services.
“We are awaiting this response and hope to ensure that the waiting list is cleared before the end of the year. The impact of implementation of this initiative on current service provision, particularly in the current Covid climate, will be minimised.”
The HSE said all eligible applications have been screened to identify probable assessments required and that a “significant number of children [up to 60%] applying for assessment of need will not meet the eligibility criteria for Disability teams and will receive their on-going interventions through either primary care or CAMHS.”