Call for ‘radical overhaul’ of Camhs service
Commission chief executive John Farrelly, Dr Susan Finnerty, commission board member Tammy Donaghy, and committee chairman Dr John Hillery, in the Mental Health Commission offices as they published their final report on Camhs. Picture: Leah Farrell/Photocall Ireland
A “radical overhaul” of how children’s mental health services operate is needed to let go of ‘old models of service’ so more children can be helped, the Mental Health Commission said.
In a scathing report published today, inspector of mental health services Dr Susan Finnerty said the lack of reform is “propping up a failing system that needs a radical overhaul” in Child and Adolescent Mental Health Services (Camhs). She called for the Commission to be given regulatory authority over Camhs, adding:
This is the second commission report on Camhs this year, following a review of the South Kerry service by Dr Sean Maskey in 2022, which found significant harm had been caused to some children.
“There was a knee-jerk reaction to crisis such as the Maskey Report or my interim report, which provided a bolus of funding to fix the immediate problem, but this is not sustainable and only addressed local problems,” Dr Finnerty added.
Some 12 of 49 recommendations made by the report address access to the service, as inspectors found “lengthy waiting lists” with an average wait between referral and assessment of three months. In Cork/Kerry this is 131 days, in Limerick/Clare and North Tipperary 72, and in the region including Waterford, 120.
The wait for children with suicidal intent is 23 days on average, and for deliberate self-harm it is 65 days. For young people with suicidal ideation, the average wait is 73 days and for eating disorders it is 54 days.
Camhs works only with children with moderate to severe mental health challenges, estimated at 2% of all children. Other services such as Jigsaw are available to deal with less severe cases.
Dr Finnerty linked staff shortages in almost all regions to waiting lists. Cork/Kerry teams had only 58% of the recommended clinical staff when inspected, and in the Midwest the figure was at 62%.
“I believe that the HSE should seriously look at the way Camhs is being delivered,” she said, saying it is not possible to fill all vacancies on the 75 teams and six specialist teams.
She called for a re-think of the reliance on psychiatrists, saying mental health treatment has evolved.
Minister for mental health Mary Butler welcomed the finding that over-prescribing identified by the Maskey report has “not been evidenced in other parts of the country.”
Responding to the call for wider regulatory authority, she said this is "already being addressed in provisions of a new Mental Health Bill, which is currently being finalised as a priority for introduction to the Oireachtas.”
The HSE apologised, saying: “We are genuinely sorry for anyone who has had a bad experience of our services.”
Chief operations officer Damien McCallion said they acknowledge the “deficits and shortcomings” highlighted, and a national office for Child and Youth Mental Health has been established.
“While investment in Camhs and youth mental health service improvement has grown over the past decade, we know improvements still need to be made and we are determined now to make substantial changes and improvements,” he said. Action has been taken around individual children where concerns were raised, he added.
Meanwhile, a teenager affected by care received at South Kerry Camhs who received a settlement of €92,500 this week has called for a public inquiry.
In response to this, Children's Minister Roderic O'Gorman said: “Before I could comment in detail on the call by that child's family, I'd like to see what the Mental Health Commission has to say in terms of their overall understanding of actions in each of the Camhs services across the country."
If you have been affected by these issues, contact Jigsaw.ie
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