Concerns over 'tsunami' of child mental health issues

The national waiting lists for Child and Adolescent Mental Health Services increased by almost 20% in 2020 while the number of children waiting for over 12 months for support rose by 25%.
Concerns over 'tsunami' of child mental health issues

Some 2,736 children were on waiting lists for CAMHS as of December, an increase of more than 400 on December 2019. The number waiting over 12 months for services rose from 212 in 2019 to 266 a year later.

The national waiting lists for Child and Adolescent Mental Health Services (CAMHS) increased by almost 20% in 2020 while the number of children waiting for over 12 months for support rose by 25%.

Some 2,736 children were on waiting lists for CAMHS as of December, an increase of more than 400 on December 2019. The number waiting over 12 months for services rose from 212 in 2019 to 266 a year later.

The HSE has pledged to try to offer children a CAMHS appointment within 12 weeks of referrals but the latest figures show that some 20% of children were not offered an appointment within that timeframe in 2020.

With waiting lists increasing and staff being redeployed to the Covid-19 frontline, services are facing increased referrals and lack the resources to deal with the surge, said consultant child and adolescent psychiatrist Maeve Doyle.

“Our big worry is that there will be a tsunami of mental health issues when this pandemic finally finishes,” said Dr Doyle, who is director of communication and public education for the College of Psychiatrists of Ireland. 

“We’re dealing with chronic underfunding which has left us with half of what we actually need and loads of great policies about mental health in the community that can’t be implemented," she said.

“In 2006, the plan, according to A Vision for Change, was that we should have 100 child and adolescent mental health teams for a population of 3.6m.

“We never reached that target and now, 15 years later, we have a population of 4.75m with 25% of them being under the age of 18.

Whether Covid is here or not, having long waiting lists for CAMHS does impact on children’s mental and emotional health and wellbeing. 

Dr Doyle said in the early stages of the pandemic people may have been reluctant to attend for mental health services, but this changed as the pandemic rumbled on.

She also outlined the impact that the rising waiting times are having on children who are already being affected by the pandemic.

“Children and adolescents will naturally be anxious during the Covid-19 pandemic — two thirds of CAMHS referrals are for anxiety disorders. These will have been made worse by the Covid situation.

“The child who is predisposed to anxiety is at home in this situation with parents who may be anxious having lost their job or trying to work from home and help with online schooling at home as well.”

A HSE spokesperson said that while Covid-19 impacted health service capacity, the level of referrals and the ability to offer appointments across community health services remain consistent with previous years.

However, HSE figures show that the service had offered 10,158 appointments in 2020 as of the end of November, compared with 11,397 appointments during the same period in 2019.

Waiting lists vary

The spokesperson said that waiting lists vary across different community health organisations where, “although some areas have relatively short waiting lists, regrettably waiting times are longer in other counties”.

She also said that children who present with more severe symptoms are on waiting lists for shorter periods of time.

There are 72 CAMHS teams in place across Ireland and these teams meet weekly to review referrals.

“Every effort is made to prioritise urgent referrals so that young people with high risk presentations are seen as soon as possible and this is often within 24 to 48 hours,” said the spokesperson.

“This may impact on wait times for cases that are considered, by a clinician, to be less severe.” 

The spokesperson also said that differences in wait times around the country could relate to the availability of CAMHS consultants, current vacancies, and difficulties in recruiting.

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