The crisis in children’s mental health services is eroding trust in treatment, the chief executive of ADHD Ireland has warned, saying calls to their support lines have doubled in recent years.
Mental Health Reform, an umbrella group for voluntary charities, has seen similar rising demand across other organisations in the last year.
ADHD Ireland offers support for all ages, but most calls are around children, Kevin Kilbride said.
“We get about 6,000 calls a year and that is increasing. A couple of years ago it was 3,000,” he said.
“Certainly within the last year, we tell people ‘the assessment route is X, Y, Z and you go through Camhs’ but people say ‘Camhs, I’m not sure I want to go there’. There has been an eroding of trust around people wanting to pursue that.”
He added: “The trend has been upwards, we have been simply overwhelmed with the tsunami of calls that we are getting.”
He said they reassure people that the HSE is working on recommendations made by Dr Sean Maskey in his report on the South Kerry Camhs, which found that hundreds of children who attended its services in the area had received substandard care.
Significant harm was caused to 46 children due to the inappropriate prescription of medication, the report revealed.
Mr Kilbride, a member of the National Oversight Group set up after this report, said: “Obviously we would like to see them doing it quicker, faster but they are taking it seriously. We can say that.”
A Mental Health Commission report on five separate Camhs, published in January, found some teams have fewer than half the recommended staff.
“There are 73 Camhs teams around the country, and 30% to 50% of everybody going through Camhs are there for an ADHD assessment and treatment,” Mr Kilbride said.
However, due to staff shortages, urgent cases including suicidal ideation are understandably prioritised, which can leave children with ADHD on long waiting lists, he said.
ADHD Ireland offers non-medical supports, and does not require a diagnosis for parents to attend support groups.
“The way we look at it is, because of the difficulties in getting a diagnosis, if a parent is dealing with it (potential ADHD), we say absolutely you can access this,” he said. “We are filling that gap.”
Mental Health Reform interim CEO Róisín Clarke said: “Charities such as ADHD Ireland provide essential support to families, often stepping into the breach when public services are unavailable or inadequate.”
"Severe shortcomings and long waiting lists in Camhs are having a knock-on effect on charities in the mental health sector."
In the last year, many organisations have seen “a significant surge in demand” from young people.
"High-quality mental health services in the public system are critical,” she said.
Only 5.1% of the overall health budget is dedicated to mental health, and she called for the Government to increase this to 10% by 2024.
Ms Clarke is critical of how voluntary groups are funded, saying funds are often allocated in an ad-hoc, precarious manner when "a secure and sustainable funding model" is needed.
Charlotte McDonnell (17) was not surprised at the latest report criticising the Camhs, having faced obstacles during her time with the services in Tipperary.
The student nurse, who previously suffered her own mental health crisis, wants dedicated mental health spaces in emergency departments, saying young people are in crisis due to long waits for Camhs help.
“I want to get mental health help for people under-18 because we are the forgotten generation,” she said.
“There is a policy of almost 'they’ll be grand' but we are not grand. People who are under-18 are losing their lives through suicide. I’ve lost people myself.”
The Carrick-on-Suir teenager now runs a free online service called the Hope Project, which offers young people information about mental health services locally, and further afield.
“There are really long waiting lists, but I do try to direct people,” she said. “I met Jigsaw. They are lovely but they deal with mild-to-moderate issues, and the severe is what is around now.
"That’s what Camhs is meant for, but because Camhs aren’t working, it is very difficult to get help there.
“It’s really hard to direct people. I want them to get help but they have to wait so long to meet someone. They might not be there when that help comes.”
Delays in the Camhs service mean hospital emergency departments (ED) are often the only option for help, she said.
“I want to have a service that works. So if someone is brought into hospital for mental health they will have a direct pathway and help when they are brought in, not faced with a two-year waiting list,” she said.
She would like to see “a nice, calm place” for mental health patients in hospitals, noting EDs are typically not designed to facilitate this.
Ms McDonnell is taking a pre-nursing course at CTI Clonmel, with placements at Tipperary University Hospital. This included a month in the ED during the winter crisis.
Her plan is to train as a paramedic, having been inspired by a female paramedic who helped her during a personal mental health crisis.
“I go to counselling now privately, I talk to my parents,” she said. “I know if I need help from the gardaí in Carrick I can go to them.
"I have that support there which is great for me, but I just wish everyone else had it.”
The Mental Health Commission interim report included North and South Tipperary Camhs. It noted while “excellent care and treatment” is available, that many children faced unsafe services and long waiting lists across four of five regions assessed.
“GPs told of frustrating attempts to get a child assessed and having to resort to sending a child to the Emergency Department in local hospitals to obtain a psychiatric assessment,” the report said.