Children could be prescribed unnecessary medication due to gaps in mental health services

Dr Patricia Byrne, Consultant Child & Adolescent Psychiatrist, and Chair of the Faculty of Child & Adolescent Psychiatry at the College of Psychiatrists. Picture: Chris Bellew

Gaps in mental health services could lead to children being prescribed unnecessary medication, the College of Psychiatrists in Ireland has warned.

The college recommended a “major overhaul” of the child & adolescent mental health services (Camhs) in a paper published on Tuesday.

They called for additional staff for each of the 75 teams, saying therapists must be given mental health training among other changes.

Dr Patricia Byrne, chair of the college’s Faculty of Child and Adolescent Psychiatry, said: “there is always a risk that when you don’t have any other options to treat that your treatment options are more limited and there may be increased use of medication.” 

Dr Byrne said a team with a family therapist and psychologist working with the lead psychiatrist can “provide a lot of interventions”. 

However, she cautioned the current situation can mean: “I may have to consider using medication at an earlier stage than I would otherwise. 

"Medication will still always be used in line with good clinical practice and governance but many children and parents or families attending the service may not have the luxury of the choice of access to a full range of psycho-therapy interventions.” 

Reform is “now critically urgent,” she urged.

Maskey Report

It is over three years since the HSE published the Maskey Report on serious problems including over-prescribing in the South Kerry Camhs.

A series of scathing reviews from the Mental Health Commission also identified gaps nationally. The college called for recommendations in these reviews to be implemented.   

Dr Byrne said young people with severe mental health challenges are getting a “variable and, at times, a sub-optimal service”.

The College has proposed each team be led by a specialist consultant psychiatrist, with new senior management roles among other changes. 

College president Dr Lorcan Martin described the proposals as offering “radical new governance and management structures” which can lay a foundation for real change.

They are sharing this document with health minister Jennifer Carroll MacNeill and other stakeholders.