AN AUDIT OF prescribing medications in the Child and Adolescent Mental Health Service (CAMHS) has found that most patients were not over-prescribed.

The independent audit, which was published by the HSE today, covers all CAMHS teams nationwide.

The audit found that most patients had medications prescribed within recommended dose ranges. 

It also found that most patients (95%) had their medication prescribed by a consultant or in consultation with a consultant. 

“We know that medication remains an important intervention in helping some young people with moderate to severe mental illness to recover and we are very aware of the importance of monitoring medications,” Dr Siobhan Ní Bhriain, consultant psychiatrist and HSE lead for integrated care, said.

“For young people attending CAMHS, medication is rarely used alone, it is usually in combination with psychological and social treatments,” she said.

“This audit found less than 50% of children attending CAMHS were prescribed medication with 95% of those having their medication prescribed by a consultant or in consultation with a consultant.”

South Kerry

This audit was commissioned after a review published in January 2022 of more than 1,300 files of children who attended the South Kerry CAMHS found that 46 children treated by a junior doctor had suffered significant harm.

It also found that 227 children being treated by the junior doctor employed at the service were exposed to the risk of significant harm due to the doctor’s diagnosis and treatment of them.

These issues included sedation, emotional and cognitive blunting, growth disturbance, serious weight changes, metabolic and endocrine disturbance, and psychological distress.

It also found that 13 other children were found to have been unnecessarily exposed to a risk of harm under the care of other doctors in the service.

That review was led by Dr Sean Maskey and Taoiseach Micheál Martin said at the time that it was a “damning indictment” of the service.

The HSE issued an apology following the publication of the report, which was sent to the families of the children involved.

Audit recommendations

The HSE said it is now addressing recommendations of the audit report published today, which include: 

• Immediate implementation of IT systems for patient records in CAMHS which will make future auditing easier and more robust and will facilitate timely communication with GPs.
• Development of national guidelines for prescribing psychotropic medication.
• Pharmacy expertise to be incorporated into CAMHS.
• Implementation of clear pathways for physical health monitoring of children on medication.

The HSE said a national drugs and therapeutics committee will be established and will carry out ongoing and additional audits.