THE IRISH MEDICAL Organisation (IMO) has criticised the suggestion by Minister for Health Stephen Donnelly that the new consultant contract will help address issues with the Child and Adolescent Mental Health Service (CAMHS). 

Donnelly yesterday said the HSE is seeking to appoint a national clinical lead for youth mental health which will bring “consistency” to how the 73 CAMHS teams across the State are regulated.

It follows a critical report into large sections of CAMHS by the Mental Health Commission (MHC) which called for “urgent and targeted action” to be taken to address risks in the service.

Yesterday morning, The Journal reported on concerns by the MHC that there is a disparity by how CAMHS teams admit young people into their care. 

It found there was a “wide variation” with one region CAMHS team accepting over 80% of children. In another, only 30% of children were accepted.

Donnelly said yesterday morning that there are “two very important new roles” being put in place for CAMHS.

“One is an assistant national director role to make sure that exactly the kind of integration that the report calls for happens.

“And critically while we have an outstanding national clinical lead for mental health the HSE now also bringing in a national clinical lead for CAMHS, for youth mental health,” he told Morning Ireland on RTÉ Radio One.

Donnelly said the role will bring a “national lens” to this look at governance and consistency across the 73 CAMHS teams.

It will also help make sure that that mental health supports and care are integrated into broader health care and social care, Donnelly added.

“One of the reasons there is so much pressure on the system right now is that since Covid, there’s been a 33% increase in referrals to youth mental health,” he said, adding that it has put the system under immense pressure.

IMO criticism 

The IMO today said Donnelly’s suggestion that a new consultant contract will help address CAMHS issues is “naive”. 

Speaking today, Professor Matthew Sadlier, Consultant Psychiatrist and member of the IMO Consultant Committee, claimed that the new contract does not address key shortcomings in the Irish health service which make it unattractive and, in cases, unsafe to work in and which are at the heart of the current crisis in CAMHS services.

Professor Sadlier said that the report on failings in the CAMHS service published this week highlighted the impact of unfunded and under-resourced structural changes.

In respect of the crisis in CAMHS, Professor Sadlier said that the crisis is the inevitable result of years of inattention and underfunding of critical health and mental health services across the State.

“The inability of the health system generally, and in this case CAMHS, to recruit sufficient number of consultants so that teams are supported and equipped to do their job, is a direct contributor to this failure in care provision,” he said.

“We have known for a long time of the unmet need of patients, and we also know that will grow significantly as a direct result of the pandemic, yet we are still woefully unprepared.”

The IMO said it believes the key issues which must be addressed in responding to this crisis are:

• Medical workforce planning for services
• Ability and funding to recruit sufficient numbers of consultants and support teams to meet patient need
• Focus on supportive services for medication management such as integration of clinical pharmacy into multi-disciplinary teams, lack of access to medical diagnostic services to community mental health teams and electronic patient records/prescribing
• Assessment of impact of moving care to the community with inadequate staffing levels and governance structures

When asked yesterday whether he would accept the MCH’s recommendation calling for the Mental Health Act to administer CAMHS, Donnelly said he and Minister of State for Mental Health Mary Butler were looking at that and “reflecting on the interim report”.

He suggested a final decision would be made following completion of the full report later this year.

Donnelly said the report also found that many young people and their families are receiving “excellent care and treatment” as approximately 20,000 young people are supported in the service.

With reporting by Eoghan Dalton