'Camhs has never been top of the agenda,' says head of mental health body

The Mental Health Commission found staff shortages and absence of an ADHD-specific entry pathway means children with severe depression or other serious issues are prioritised ahead of children with ADHD. File picture

Children’s mental health has never been top of the agenda, and unless that changes families will face the same problems in 10 years time, ADHD Ireland has warned.

Between 30% and 50% of children attending Child & Adolescent Mental Health Services (Camhs) are referred for ADHD, Ken Kilbride, CEO of ADHD Ireland said.

He was responding to a critical report by the Mental Health Commission which found a failing Camhs system and said ADHD is the second-most prevalent mental disorder for young people.

“How did we get to a situation where we have this under-funding and under-resourcing of Camhs?” he said. “I think it’s down to the fact that children with mental health conditions didn’t receive the priority they required. The Camhs service has never been top of the agenda.” 

While he welcomed political concern around the report, he called for investment. “It’s great to see the issues out in black and white, there is lots of recommendations in (the Commission report) and a lot of good stuff that needs to be done,” he said. 

“But my concern is without systemic change within the HSE around funding, around recruitment, that we will be having the same conversation 10 years from now.” 

Staff shortages

There are 75 Camhs teams but only two specialist ADHD teams so far under a new initiative with funding approved for a third in Cork/Kerry, according to the Commission. They recommended fast-tracking additional specialist teams and developing a model of care for children. 

ADHD is “manageable and very treatable” once children get the right treatment, Mr Kilbride stressed.

“For Ireland, the place to get that is through Camhs, so we want to see the Camhs working properly, providing all that assessment and treatment in the right place at the right time as per Sharing the Vision,” he said, referring to a government policy.

The Commission found staff shortages and absence of an ADHD-specific entry pathway means children with severe depression or other serious issues are prioritised ahead of children with ADHD. Those children get bumped down the list and their symptoms or problems at school worsen, Mr Kilbride said.

“An ADHD pathway is a great idea,” he said. “We’ve heard from Camhs they operate on the basis of priority so they literally have a separate waiting list for ADHD which they get around to when they can. So they are getting the treatment, but it’s a year or two years down the road.” 

He echoed the Commission’s call for focus on staff other than psychiatrists, saying parents experience shortages of speech & language therapists, occupational therapists and social workers.

These gaps have consequences, he warned: 

Pills don’t build skills. Medication for a lot of people is an important part of the treatment but it is part of the treatment.

Mr Kilbride, who is on the oversight group for implementing a report by Dr Sean Maskey in 2022, said change has started on some issues.

“There is positive stuff there as well,” he said. “The HSE is working through the Maskey recommendations at a rapid rate to be honest. There is a commitment from the top of the HSE to get this right.”