Hold HSE bosses to account for crisis in child mental health services, medics urge

Dr Kieran Moore, a child and adolescent psychiatrist with CHI at Crumlin said shortages are directly impacting children.

Managers should be held accountable for the growing crisis in child mental health services as HSE data now shows 3,357 children on waiting lists, leading psychiatrists have said.

This follows a shocking report into the prescribing of excessive medication to children in South Kerry under the Child and adolescent mental health services (Camhs).

 A senior consultant post was not filled for over five years, leaving an inexperienced psychiatrist working alone.

In response to a Garda appeal, a number of families in Kerry have made preliminary contact with the force to make criminal complaints, according to local solicitor, Padraig O’ Connell.

The latest data shows there were 221 children waiting more than a year for treatment as of November, up from 170 in August when the overall figure was 2,284.

Overall 20% of children waiting are in Cork and Kerry. This area has the longest waiting lists at 682 and the highest number waiting more than one year at 97.

Dr Kieran Moore, a child and adolescent psychiatrist with CHI at Crumlin said shortages are directly impacting children.

“Nobody is talking about the suffering these children and their families go through. Parents are bawling when they come in here,” he said. 

“No matter where they go, everyone turns them down except A&E so they end up here. It angers me.” 

Dr Moore, who resigned from Camhs in 2018, called for greater accountability.

“We are all regulated, except HSE managers. We have a tranche of thousands of workers who, if they do something or don’t do something, there is no fitness to practice (as there is for doctors and nurses),” he said.

Dr Maeve Doyle, director of external affairs and policy with the College of Psychiatry, said the national situation is “extremely worrying”.

The child psychiatrist said long lists raise questions about how recruitment is managed as psychiatrists can highlight their team is overworked but cannot temporarily close a list or increase staffing. 

“There does need to be root and branch review of management and accountability processes,” she said.

I would be very worried about the impact on children and families. If they are waiting that length on a list, they would go from maybe being routine to becoming more urgent and more severe. 

The Camhs list for Clare, Limerick and North Tipperary, has 299 including 74 waiting over a year. Camhs across south Tipperary, Waterford, Carlow and Kilkenny has 326 listed including 13 for one year or more.

No child is waiting longer than 39 weeks for Camhs across Galway, Mayo, Roscommon and there are 119 on this list.

A note attached to the figures, released to Labour Td Sean Sherlock, from Jim Ryan, HSE national mental health services states: “Differences around the country relate to the availability of specialist Camhs clinicians, current vacancies and difficulties in recruiting in an international capacity." 

The Mental Health Commission (MHC) has now written to the minister for mental health Mary Butler, warning the South Kerry report shows “catastrophic failure of oversight, supervision and accountability underpinned by failings of governance at local, regional and national level.”