Scandal in child mental health service linked to 'institutional misogyny'

A former principal social worker in Camhs claims that institutional misogyny could have played a role in why warnings about a lack of clinical governance were not properly addressed.

A former principal social worker in the Child and Adolescent Mental Health Service (Camhs) has queried why repeated warnings about a lack of clinical governance in the service were not properly addressed, suggesting it could be due to "institutional misogyny".

The comments are made by Joan Cronin, who currently lectures in social work in the School of Applied Social Studies in University College Cork but who worked as a principal social worker and family therapist in Camhs from 2000 to 2016.

Writing in today's Irish Examiner, Ms Cronin said she worked in a Camhs team in Cork without a consultant psychiatrist for many years and "on a weekly basis, I met and wrote to the line managers expressing concerns regarding the lack of clinical governance".

Those issues included waiting lists, non-review of children's medication, and poor supervision of junior doctors.

"Our complaints, put in writing, were consistently minimised. We can’t find consultant child and adolescent psychiatrists to work here," she said.

"When the Kerry Camhs scandal broke, the acknowledgement was given to the doctor who raised the concerns in Kerry, similar to concerns I had raised for years in Cork. 

"Why was I not listened to? Was it because of patriarchy, casual sexism, and institutional misogyny so well known in Irish healthcare services? Maybe so."

She also said a look back review to consider the potential clinical issue relating to the clinical practices in prescribing, care planning, diagnostics, and clinical supervision in Camhs South Lee between 2010 and 2017 is "urgently warranted".

Ms Cronin's comments came after the Irish Association of Social Workers (IASW) said it was very concerned at the findings in the recently-published Maskey Report on the situation in Kerry Camhs, and after an Oireachtas Committee heard what had happened there was due to a "systems failure".

Last week the Irish Examiner revealed that a third of referrals to Camhs last year were rejected, and the IASW asked what happens to young people who are not accepted into the service.

IASW chairman, Vivian Geiran, said he welcomed confirmation that a national audit would take place but stressed that the system is under-resourced.

The Oireachtas Sub-Committee on Mental Health heard from the chief executive of the Irish Medical Organisation, Susan Clyne, who 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 other services, following a decade of austerity that had been pre-dated by more than a decade of inattention to mental health services.

She said child and adolescent psychiatrists were being "headhunted" in other countries and that 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 stressful" and where the solution was sometimes offered of "just do a bit of baking or yoga at the weekend".