Camhs ‘limping along’ with too few staff, warns College of Psychiatrists

“It recommended, for a population of 3.6m then, 100 child and adolescent mental health teams. What we have in 2022 is 72 teams,” said Dr Doyle.  Picture: PA

The Child and Adolescent Mental Health Service (Camhs) is “limping along” with just 72 teams when 130 are needed, the College of Psychiatrists has said.

Many of the existing Camhs teams have half the staff they need, according to Dr Maeve Doyle, director of external affairs and policy with the college.

Dr Doyle highlighted the staff shortages in Camhs as separate HSE figures show 9,554 children are waiting on primary psychology services — an early stage treatment for children's with milder mental health conditions — with Cork and Kerry the worst–affected areas.

Children waiting for primary psychology services often end up needing the help of specialists in Camhs because their condition, which goes untreated on long waiting lists, deteriorates to the point where they have severe mental health problems.  

Reform plans for Camhs were laid out clearly as far back as 2006, but have never materialised.

Falling short

“It recommended, for a population of 3.6m then, 100 child and adolescent mental health teams. What we have in 2022 is 72 teams,” said Dr Doyle. 

“It also recommended 11 different disciplines on those teams, with the consultant as the head of the team and with psychology, occupational therapy, speech & language therapy, clinical nurse specialists, sometimes two of each, plus admin support.” 

Ireland’s population is now over 5m with around 25% aged under-18.

“So you would, at least, need about 130 teams to deliver the kind of service that was envisaged,” said Dr Doyle, a child and adolescent psychiatrist.

“We were limping along even before the pandemic with 72 teams, not 100, and only 50% of the disciplines on the teams. Do the maths.” 

A report into serious failings in the South Kerry Camhs, published last week, highlighted the detrimental effects of not recruiting a senior consultant for five years.

“Insufficient understanding, recognition and attention has been given to the indirect and slowly developing risks arising from the absence of the clinical lead role,” it said.

Reacting to the report, the HSE said services for less severely-ill children are being improved to reduce Camhs workloads.

Longest waits

However new figures show Cork and Kerry has one of the longest primary psychology lists with 2,112 children or 22% of the total. Only Dublin has more. Up to January 20, Cork/Kerry listed 856 children waiting more than one year. 

In contrast, Clare, Limerick and North Tipperary have the shortest list with 414 children or 4.3% of the total, although there are 136 children waiting 12 months or more. 

West Cork GP Laura Cullen said: “I was speaking with some colleagues about this, and the wait is so long sometimes for community psychology that you are reluctant to make a referral because you know what the wait is. Your concern is you are adding to the distress.” 

The figures were released to Labour TD Sean Sherlock, who said: “There shouldn’t be a reason why files can’t be transferred to other parts of the country where there is capacity and imaginative solutions found to provide therapy.”