Kerry Camhs scandal '100% a systems failure', committee told

IMO chief executive Susan Clyne said what had taken place in Kerry may well be replicated across services, and not just limited to those in mental health, following a decade of austerity that had been predated by more than a decade of inattention to mental health services. File picture: Gareth Chaney/Collins

The Irish Medical Organisation has said what happened in South Kerry Camhs was not a shock and "100% a systems failure".

Speaking to the Oireachtas sub-committee on mental health, the IMO's chief executive Susan Clyne said the inability of the Irish health system to hire sufficient people in senior roles, particularly at consultant level, meant it was unattractive to newly-qualified personnel who were being "headhunted" by other countries.

Ms Clyne, said: "I am really sorry to say we are not shocked but it is 100% a systems failure".

She said what had taken place in Kerry may well be replicated across services, and not just limited to those in mental health, following a decade of austerity that had been predated by more than a decade of inattention to mental health services.

She said Irish child and adolescent psychiatrists were being "headhunted" in other countries and it was hard to convince people to stay or return to work in Ireland when "we are asking people to come into working environments that are extraordinarily successful" and where the solution was sometimes offered of "just do a bit of baking or yoga at the weekend".

Dr Anne Doherty of the Irish Hospitals Consultants Association said: "If a system is under such strain, it is not an attractive place to work."

Strong criticism

The committee heard strong criticism of various aspects of the current system and of some of the proposals being brought forward under the Mental Health (Amendment) Bill 2022.

The draft bill is undergoing pre-legislative scrutiny before the committee and one speaker, Prof Matthew Sadlier, said a proposal that only authorised officers would be allowed to make an application to a medical practitioner for involuntary detention was unlikely to work.

He likened the proposal to someone not being able to call an ambulance, and instead having to wait for someone else to arrive, assess the situation, and then decide to call the ambulance. Another IMO representative, Dr Aideen Brides, said the idea was "beyond comprehension".

Last week the Irish Examiner revealed that a third of referrals to Camhs last year were rejected, and the Irish Association of Social Workers has now queried what happens to young people who are not accepted into Camhs.

Dr Brides said sometimes a child could be referred to Camhs, with the clinician making the referrals knowing it was not the best place for them, but due to "fragmentation of services" it could be hard to know where best to send them.

Prof Sadlier said: "The services are under-resourced, this is a core problem, but we also know they are poorly structured."

He said there was a need to align the age definition of a child across all services, given some services are only open to those aged 16 or under, although Prof Brendan Doody, child and adolescent psychiatrist at the HSE's Linn Dara in-patient unit, said the number of hours spent by teenagers in adult acute facilities was very low, albeit needed to be minimised as much as possible.

The committee heard there needed to be more supports at primary care level and that "postcode lotteries" existed regarding access to services. Separate from the committee, IASW chairman Vivian Geiran said he welcomed confirmation that a national audit within Camhs would take place, but stressed the system was under-resourced.

"The report on Kerry Camhs is a worrying example of systemic failure," he said. "It highlights the need for clear oversight and governance structures to be in place in Camhs services around the country."