MHC report 'cruelly exposes' HSE failure to staff child mental health services

The MHC interim report highlighted the number of young people who did not receive adequate or timely follow-up, many of whom were on medication. File picture: Pexels

The damning findings of the Mental Health Commission into a raft of problems with Child and Adolescent Mental Health Services (Camhs) has sparked a wave of criticism and calls for Camhs to be overhauled.

Tánaiste Micheál Martin described the findings in the MHC interim report as "unacceptable" and "very, very concerning", with opposition parties also joining in the chorus of criticism.

The HSE has stressed that it is already taking steps to address many of the problems highlighted in the report, but groups representing medics and organisations that support patients said the report laid bare the poor state of mental health services in this country.

Vice President of the Irish Hospital Consultant Association (IHCA) and Consultant Liaison Psychiatrist, Professor Anne Doherty, said the MHC report had "cruelly exposed" the failure by the HSE to adequately staff key parts of the health service.

"The failings identified in the interim report unfortunately come as little surprise to consultants working in frontline Mental Health Services on a daily basis and who have been desperately highlighting the need for more specialists and greater capacity across the board for years," Prof. Doherty said.

"The HSE’s own data shows that our services are missing at least a third (29%) of the required Child and Adolescent Psychiatry Consultants, as these permanent posts remain vacant or filled on a temporary basis.

Our system is letting some of our youngest and most vulnerable patients down, putting their health and safety at risk.

"A key response to this crisis is filling the one-in-three vacant permanent Consultant Psychiatry posts urgently, but as we know, it is increasingly difficult to do so."

One CHO with just such a vacant post is in South Kerry Camhs, which a year ago was the subject of a critical report by Dr Sean Maskey highlighting major concerns, including inappropriate and excessive medication.

That issue was again at the forefront of the MHC interim report, which highlighted the number of young people who did not receive adequate or timely follow-up, many of whom were on medication.

Róisín Clarke, Interim CEO, Mental Health Reform said: “This report is a damning indictment of the deepening crisis in our mental health services. Persistent failures of clinical oversight are putting children’s safety at risk.

"It is now clear that poor clinical governance is a national issue across the mental health system. The failure to manage risk, recruit key staff and provide standardised care is resulting in dysfunctional and unsafe mental health services for children and young people.

"It is deeply alarming that some Camhs teams are neglecting to monitor children using anti-psychotic medication. Also of serious concern is the lack of follow-up care for children."

Tanya Ward, CEO of the Children's Rights Alliance, said the findings in the MHC report were "disturbing", particularly when young people needed the service more than ever.

Tánaiste Micheál Martin said governance issues would need to be reviewed in Camhs, and added: "The numbers going forward for treatment has increased very significantly, the referrals have increased very significantly, but still, no child should be lost in the system.” 

His ministerial colleague, Minister of State for Mental Health and Older People, Mary Butler, told RTÉ that she was also concerned with governance issues within Camhs and said she found it difficult to believe that some CHOs were still working off a paper-based system.

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There was a need for real-time data and an independent evaluation, she said, “then we can sit down and decide the best way forward”. 

Sinn Féin spokesperson on Mental Health, Mark Ward, said Ms Butler needed to make a statement on the MHC report and urged the Oireachtas Mental Health Committee to invite the HSE before it to address the contents of the report, with the situation "now gone way beyond crisis point when it comes to our children’s mental health".

Damien McCallion, HSE Chief Operations Officer, stressed that when concerns regarding individual children were flagged through a draft copy of the MHC report late last year, action was taken, including regarding the 140 ‘lost’ cases in one CHO area, the Mid West. He said another 28 cases were identified elsewhere.

"In the case of all children where concerns have been raised by the MHC in their report, these have been managed directly by the service caring for them," he said, adding that part of the response would be appointing clinical and operational leads for Camhs, as well as additional training.

The HSE also emphasised that the MHC report also praised the efforts to staff who were working hard to provide a good service. The MHC report also identified one CHO where an independently provided Camhs service was providing excellent care.

Anyone with concerns can call the HSELive number at 1800 700700.