More children waiting for mental health services in Cork and Kerry than any other region

Maurice O'Connell with his son Jason: 'Our children are shutting down.' Pictures: Alan Landers.

There are more children waiting longer than one year for mental health services in Cork and Kerry than in any other HSE region, startling new figures show.

One father in the South Kerry region said his son and other children continue to suffer long-term effects of an over-prescribing scandal in 2022, saying “our children are shutting down”.

The HSE still cannot say when a 2023 look-back review into children’s care under the North Kerry Camhs will be published.

The national staffing crisis is so “frightening” just 25% of people needed across all intellectual disability teams are in place for Child and Adolescent Mental Health Services (Camhs).

There are 332 children in Cork and Kerry waiting more than 52 weeks for a Camhs appointment, among 712 children waiting this long nationally. In response, the HSE Southwest admitted “demand for the service continues to outstrip supply”.

The number of referrals is rising “steadily year on year”, it said, partly caused by economic and social stresses. It also said young people were more likely to seek help now for mental health issues.

The two Kerry Camhs teams are still coping with fall-out from controversy about over-prescribing of medication and incorrect diagnosis.

In 2022, the Maskey Report found in South Kerry, care for 240 children and teenagers did not meet standards. It was critical of an absence of senior clinical staff.

It said “significant harm” was caused to 46 children. This included serious weight changes, elevated blood pressure and production of breast milk.

A compensation scheme set up in April 2022 is run by the State Claims Agency for the HSE.

By Friday, this had received 231 applications. An SCA spokesman said just five had not yet received a payment on account.

The process included 111 mediations between the State and families.

However, he could not comment on the amounts because the process is still continuing. 

The father of one child, Maurice O' Connell, said their family is still waiting for an appointment having had one cancelled last October. 

In 2022, concern was raised by families in North Kerry about potential for a similar crisis there. A look-back review led by Dr Colette Halpin opened in June 2023 involving 300 children.

“We sincerely regret that this review process has taken longer than we initially hoped, and we apologise to the young people involved and their families,” HSE Southwest said on Friday. 

The families have been told what was found out at individual meetings already. However work continues on recommendations.

“We are determined to have a final report that is comprehensive and informed,” it said.

These counties had funding for 24 new posts last year but still struggle to fill all vacancies. 

The North Kerry team has four vacancies. This includes for a clinical psychologist with an assistant hired for the interim.

“Psychology vacancies have been particularly problematic to fill,” the spokeswoman said.

South Kerry is down an occupational therapist. Across the county, psychiatry is given through a mix of online and in-person appointments.

National waiting lists

The HSE Mid-West region has the lowest number of children on waiting lists for Camhs, at just 189 overall.

Most of these, 74, have been waiting less than 12 weeks and 17 have waited longer than one year.

A spokesman said they had filled vacant posts on its teams. Each team runs a waiting list initiative to make sure wait times are a priority.

They were funded for seven new posts in the HSE’s service plan for this year.

The Dublin and North East region, including Louth, has 216 children waiting over 12 months for an appointment. Overall, it has the highest number of children on its lists at 1,064. 

Camhs in intellectual disability teams

Camhs also provide intellectual disability teams around the country. These should each have 11 staff.

However, HSE Mental Health Services said staff numbers were at “approximately 25% of the recommendations for staffing”.

The North-West counties have no team and advertisements for two psychiatrists had no applicants.

“In other parts of the country, teams consist of one or two team members,” it said. This means usually a consultant adolescent psychiatrist and one other person.

It supplied numbers for funded posts but said: “Some of these posts are vacant due to staff having left, who have not been replaced, maternity and sick leave.” 

HSE South-West said the Cork team had eight staff now, including a psychiatrist and clinical nurse specialist. 

The Kerry team is being expanded. A psychiatrist works part-time between in-person and online appointments supported by another working on a pro rata basis. It has a non-consultant hospital doctor, also part-time.

The HSE Mid-West said its team has five people. The Dublin and North-East region's team has six staff.

Reaction

The data on Camhs and Camhs intellectual disability teams was released to Sinn Féin disability spokesman Ruairí Ó Murchú. 

“There has been much commentary in relation to Camhs, and the frightening aspect of the figures is the number of positions unfilled,” he warned.

“The capacity of the service to deliver is impacted."

He cautioned these figures may not give the full picture, noting disputes between health unions and the HSE around recruitment figures.

In his own region around Louth, he said services historically had low residential bed numbers.

“There’s a wider conversation needed around mental health services,” he said.

He also called for solutions to divisions between Camhs and other services. This can mean children getting multiple referrals.

“We really need to make sure that that happens. In most cases, parents are looking for solutions in relation to their child and we need to be able to facilitate that,” he said.

He called for an end to “overly-cumbersome bureaucracy and the games of ping-pong [between services] that can occur from time to time.”

Mary Butler, minister of state for mental health, has focused on reducing the waiting lists and creating better links with other services, a spokeswoman said.

“Camhs receives approximately €167m in dedicated funding annually; this is an increase of €30m, or 18%, since 2023,” she said.

In September, the equivalent of 857 full-time people were working in Camhs, including 728 clinical posts.

The budget included €2.7m for two new mental health teams, with intellectual disability teams and one for eating disorders. It gave €3.4m for a new crisis service with 19 new Camhs doctors.

Ms Butler met with 21 Camhs teams in the last six months and the HSE regional executive officers on this. 

The Department of Health said referrals to Camhs increased by more than 47% between 2020 and last year.

By September this year, 21,400 referrals were made. It said while waiting list numbers were high, numbers waiting over 12 months have dropped by 25% since April.

The minister's spokeswoman acknowledged the delay in publishing the North Kerry report but said she understood it would be made available as soon as possible.

One family's experience with Kerry Camhs

“Our children are shutting down."

Maurice O'Connell with his son Jason: 'He went from a bright, bubbly boy of 11 years of age to a child that was depressed, anxious, had tics, was sometimes violent and everything else' Picture: Alan Landers.

Those are the words of the father of one boy affected by the over-prescribing of mental health medicines in Kerry, as the family still waits for a compensation hearing.

Maurice O’Connell’s son Jason was put on medicine called risperidone, mainly used for adults with schizophrenia. He has ADHD.

“He went from a bright, bubbly boy of 11 years of age to a child that was depressed, anxious, had tics, was sometimes violent and everything else,” Mr O’ Connell said.

His son left school at 15, fleeing the bullying linked to weight gain temporarily caused by the medication.

It was around then, too when a new psychiatrist Dr Maya Sharma saw him and immediately stopped the tablets.

Dr Sharma later turned whistleblower on the crisis.

Mr O’Connell describes that time as “lost years” for his son, saying the teen’s memories are “foggy” and adding quietly: “He isolates himself now still.” 

Jason’s final years with Camhs were under a psychiatrist living in Dubai, arranged by the HSE. Appointments were on Zoom, mainly with in-person slots available once a month in Kerry.

Now 18, he has been discharged, and the family is hopeful he can get a psychologist through the adult system. He is on a waiting list.

The cost of private care at up to €130 an hour is “out of reach”, his father said. It would mean travel as well to Cork or Limerick from their home in Caherciveen.

This is where the State compensation scheme, set up in April 2022, should help.

“I’m still waiting to be seen by the redress,” Mr O’Connell said. “Last October, I was supposed to go to them, and they cancelled it. And we’ve heard nothing since.

“We’ve had no appointments with them. I have not even been given a date.” 

He is aware other families have received compensation but said: “As far as I can see, the redress is very, very disappointing.” 

He has heard of payments between €40,000 and €70,000, with one at €120,000.

“The figures being paid out are not great for the damage that they’re done,” he said.

“People were happy at the time because they didn’t want to go through the high court. A lot of parents were very upset, and they just wanted the thing to be over.” 

The family are in parallel pursuing a high court action. In the meantime, he warned: “My son has fallen through the cracks”.

He pointed out that Jason’s younger siblings were indirectly affected too, seeing their brother suffer and change.

It feels, he said, as though the government and HSE are “throwing money at people".

"Then once that’s done, their hands are clean. You are left then with the aftermath of it.”