Sustained investment and 'cultural shift' needed in Camhs
The report said communication difficulties and breakdowns in trust between caregivers and Camhs professionals often left families 'feeling marginalised, blamed, and fearful of speaking up'. File photo
Families should be given a central role in the care of their children by the Child and Adolescent Mental Health Service (Camhs), according to professionals and researchers attached to the service.
Parents told researchers of significant problems caused by the lack of staffing and resources as well as poor communication and perceived attitudes of clinicians.
The authors said that although they were “clinicians and researchers embedded in Camhs” they sought to ensure that the voices of the families were to the fore of their study.
The research team comprised of three child and adolescent psychiatrists — two consultants and one senior registrar — and two pharmacists.
The study was conducted among 22 care-givers — 20 mothers, one father and one grandfather — who were among 236 respondents in a national online survey.
The report said positive accounts were “relatively rare, yet meaningful” and could take seemingly basic forms: “Caregivers described how seemingly small, humanising gestures, such as being greeted by name on arrival or receiving a personal check-in from staff fostered a sense of being seen and valued in an otherwise difficult system."
Parents valued multidisciplinary support, including where their child had “access to a range of therapeutic supports alongside psychiatry and medications” and saw peer support as “a powerful means for reducing isolation and mental health stigma”.
Families reported that sensational or critical reporting sometimes led to “increased clinician anxiety”, including abrupt changes in treatment and confusion for care givers.
This included a shift in the attitude of clinicians to medication.
The report said: “While responsible journalism can promote accountability and drive necessary reform, negative or sensational coverage may also undermine trust, destabilise collaborative care, and heighten stress for both families and clinicians.”
The report said communication difficulties and breakdowns in trust between caregivers and Camhs professionals often left families “feeling marginalised, blamed, and fearful of speaking up”.
It said families described experiences of being “talked over, dismissed, or not taken seriously” during consultations.
Some interpreted clinicians’ body language, such as continued note taking, as a sign that their concerns were not truly being heard.
“Fear of repercussions also emerged as a recurring concern," it said.
It said this “climate of caution” discouraged honest dialogue and eroded trust.
Many parents described the service as “fragmented and impersonal”, governed by rigid protocols.
The perceived “one-size-fits-all” approach left caregivers feeling care was reduced to a “checklist”.
The report said: “A recurring issue was the over-reliance on medication in the absence of meaningful alternatives. Families frequently reported that psychological therapies or practical supports were unavailable, and that care was primarily pharmacological.
“This contributed to feelings of exclusion and frustration, with many describing the process as reductive and alienating. There were repeated calls for more holistic and multidisciplinary approaches that recognised wider psychosocial needs.”
Families said disruptions in care were a major concern. Frequent staff changes, particularly due to trainee doctor rotations, led to forgotten plans and loss of therapeutic trust.
The report said “abrupt transitions” to adult services, marked by poor discharge planning and difficulty accessing medication, left families “navigating critical gaps alone”.
The report said “chronic understaffing” is a central concern of families.
“Caregivers highlighted the emotional and operational toll on clinicians, with burnout, high turnover, and inadequate support across both clinical and administrative roles,” it said.
Many parents linked workforce instability to lack of therapies, diminished quality of care and prolonged gaps between appointments.
“Caregivers described waiting up to four years for initial appointments, with little or no interim support.”
Highlighting the crises families face out of hours, the report said: “A lack of psychological input, especially during crises, was particularly distressing. Some described being referred to emergency departments for urgent mental health needs, reflecting a system unable to provide timely or appropriate therapeutic intervention.”
Many parents told researchers of being “bounced” between Camhs and disability services, with neither team taking responsibility for complex presentations involving neurodivergence and co-occurring psychiatric disorders.
“A recurring analytic pattern was the perceived tendency for Camhs to attribute all presenting difficulties to autism spectrum disorder (ASD), restricting access to mental health care,” the report said.
Parents said the mainstream interventions were not adapted for neurodivergent children.
The report added: “Missed or delayed diagnoses were another common concern, with families often forced to seek private assessments to obtain an ASD diagnosis, which subsequently may not be accepted by services.”
The researchers were clear in their conclusions: “Our findings highlight the need for both structural reform and cultural transformation within Camhs.
“Addressing chronic staff shortages, outdated infrastructure, long waitlists, and fragmented service pathways requires urgent and sustained investment, with funding ring-fenced within the national health budget to prevent diversion.”
The report said a dedicated strategy is needed for recruiting, retaining, and supporting multidisciplinary teams.
“This should include the development of roles such as family support workers, alongside mandatory, ongoing training in neuroinclusion and trauma-informed care," it said.
It said family-centred practice is “critical” and that caregivers should be “active partners”, with formal mechanisms for incorporating family feedback into services.
The report called for the establishment of “family advisory councils” across Camhs regions, “independent audits” of family involvement, and annual public reporting on wait times and satisfaction.
It said families must be able to raise concerns without fear of repercussions.
The research team comprised of Laura Bond, clinical lecturer at UCD School of Medicine, Aoife Gordon, senior registrar in child and adolescent psychiatry, Rebecca Parkin and John Hayden, both senior pharmacists at the Royal College of Surgeons, Suzanne Guerin, professor of Psychology at UCD and Fiona McNicholas, consultant child and adolescent psychiatrist.
CONNECT WITH US TODAY
Be the first to know the latest news and updates
