The HSE welcomes the publication today (Wednesday 26th July 2023) of the final report of the Mental Health Commission (MHC) on the Child and Adolescent Mental Health Service (CAMHS). This report comes after a long process in which the HSE was happy to engage in, with much work done since the publication of an interim report last January.
We are pleased to see the report acknowledge the hard work and dedication of many working in this complex service are, one for which there is increasing demand. We know that there is inconsistency across the country and that must be part of our continuous improvement plans.
We acknowledge the real concerns the report raises in areas such as service delivery, staffing and governance as well as specific concerns regarding children and young people in the care of CAMHS. We are genuinely sorry for anyone who has had a bad experience of our services. It is the responsibility of all in the HSE management, medical, nursing, allied health professionals and administrative staff to work together and change if we are to make services more responsive in both access and quality of outcome.
Speaking about the report Damien McCallion, HSE Chief Operations Officer said, “When we received the interim report late last year, we took the action necessary to address issues in relation to specific service users. However the interim and final reports also point to deficits and shortcomings in the service we provide to children and families, and we acknowledge these and have a programme of work now to address these issues.
“While investment 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 in the mental health services provided in Ireland to children and adolescents.”
The steps we are taking include;
- The progressing of a new HSE Child and Youth Mental Health Service improvement programme
- The establishment of a new national office for Child and Youth Mental Health which will lead out on this programme to provide leadership, oversight and enhanced governance to services.
- The appointment of both a National Lead and a National Clinical Lead (CAMHS Psychiatrist) for Child and Youth Mental Health to lead this office and the service improvement programme.
Our CEO and national leadership will be having detailed discussions with the Commission to ensure our plans are realistic, timebound and achievable and we have the full support of the Department, Minister Butler and Minister Donnelly in that effort.
In addition to the work of the MHC we have conducted our own targeted learning initiatives.
- An audit of prescribing practice around the country which in the main said there was no evidence of over-prescribing and that most patients (95%) had their medication prescribed by a consultant or in consultation with a consultant.
- An audit of adherence to the CAMHS operational guidelines which in the main said all teams were aware of the guidelines and all teams were in the process of implementing the guidelines.
Also, as recommended by the MHC interim report we have completed a review of all open cases which had not had follow up appointments in the previous six months, and of those who had been prescribed neuroleptic medication. Out of an overall caseload of close to 20,000 children and young people, a total of 576 open cases were identified. We have contacted all of these, ensured they are receiving appropriate care and we have not identified harm caused to any of these individuals.
These audits help us to identify where best to focus on reducing inconsistence and pursuing continuous improvement in the services.
In our new organisational structures and approaches to working (Regional Health Areas) we will strengthen the integration between CAMHS and other services Primary Care, Disability, Acute Hospitals, Social Inclusion. We know that our children do not stand in one serviced or policy area and there is also work for other state agencies in respect of integration including Education and Youth Justice.
Child and Youth Mental Health Service Improvement Programme
This is an initiative to build capacity in CAMHS and youth mental health. It will develop specialist services and clinical programmes, suicide prevention initiatives and primary care mental health services. It will also modernise forensic services and develop digital platforms for accessing services. It is however important to understand that this is a process, an amount of which will not depend on funding but on the ability to recruit expert staff, expand teams and retain them in a highly competitive global workforce market.
Any parent or guardian with a concern or query about their child who is currently attending CAMHS should contact their child’s team directly, or they can call HSELive at 1800 700 700 who will take their details and arrange for someone from their CAMHS team to contact them if necessary.
Mr McCallion said: “We are glad to note that the Mental Health Commission states in their report that many young people and their families have received excellent care and treatment within the often-limited resources of CAMHS teams who have nearly 20,000 cases nationally and see 225,000 appointments annually. It is our intention that this would be the case for all and we know the challenges in making that happen. While acknowledging the significant challenges we face, we encourage anyone engaged with a CAMHS service to stay connected to their team.”
Last updated on: 26 / 07 / 2023
