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Mark Ward speaking in the Dáil this evening
Mental Health

'We're letting children drop off a cliff edge at age 18': Opposition hits out at CAMHS issues

Sinn Féin’s spokesperson for mental health said it is “downright scandalous” that some young people are not receiving follow-up care such as essential blood tests.

THE GOVERNMENT NEEDS to take urgent action to ensure children and young people attending Child and Adolescent Mental Health Services (CAMHS) receive appropriate care, the Dáil has heard.

Mark Ward, Sinn Féin’s spokesperson for mental health, said it is “downright scandalous” that some young people are not receiving follow-up care such as essential blood tests.

According to a recent report compiled by the Mental Health Commission, some children and young adults who should have had follow-up appointments via CAMHS – including for review of prescriptions or monitoring of medication – did not have an appointment for up to two years.

In certain cases when people turned 18, there was no planning, discharge or transition to adult services.

Speaking in the chamber this evening, Ward said: “We need a plan for expanding CAMHS to help young adults up to the age of 25, this is international best practice. Currently we are letting children drop off a cliff edge at the age of 18.”

The MHC’s interim report into an independent review of the provision of CAMHS found that many children and young people end up “lost” in the system.

Ward noted that in one catchment area, there were 140 “lost” cases within the local CAMHS team, describing this as “a complete mess” and saying children are being put at “unacceptable risk”.  

“Every resource possible must be put in place into finding these lost children and making sure that the appropriate treatment plan is in place for them. A complete clinical review of every open case must be done as a matter of urgency,” he said.

Ward also called on the government to “set national standards for monitoring the use of antipsychotic medications by children and young people”.

“This should be part of new regulations under the Mental Health Act focused on regulating CAMHS. It is clearly needed to ensure that no more children are given strong medication and then simply forgotten about,” he added.

‘Urgent action needed’ 

The Inspector of Mental Health Services, Dr Susan Finnerty, decided to produce an interim report due to “the serious concerns and consequent risks for some patients”. She has called for “urgent and targeted action” to be taken to address these risks.

On foot of the interim report, the HSE confirmed it is carrying out a review into the situation.

Also speaking in the Dáil this evening, Mary Butler, the Minister for Mental Health, said the government is “fully committed to the delivery of high quality, person-centered recovery-orientated mental health services”.

The stark findings in Dr Finnerty’s report come a year after a review into CAMHS services in South Kerry.

The review, carried out by Dr Seán Maskey, found that the care received by 240 young people in the area “did not meet the standards which it should have”.

The Maskey Review, published by the HSE in January 2022, found that 46 of the children suffered “significant harm” while attending the service.

It also found that 227 children being treated by a non-consultant 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. The HSE apologised to the young people and their families at the time.

Quality and safety 

Butler today said that this week’s interim report is “a timely contribution to the common objective of improving CAMHS overall, especially when it comes to quality and safety”.

“Following on from several meetings to discuss the Maskey Report this time last year, I asked the Mental Health Commission to expand the remit of their annual thematic report to take cognisance of the Maskey Report which had been recently published.

“I was also pleased, Ceann Comhairle, to provide the necessary resources to the Mental Health Commission to enable this comprehensive review to take place, running in parallel with the HSE’s national CAMHS audits.

“I look forward to the publication of the full report later this year and the relevant data supporting the findings. And I would like to take the opportunity to thank Dr Susan Finnerty and her team for their work to date.”

Butler said the government is committed to implementing the 35 recommendations included in the Maskey Report. She noted that, to date, these recommendations have resulted in “63 actions, 19 of which – national and local – have been implemented with others underway”.

She said the information arising from the various reviews currently being carried out into CAMHS “will be used to ensure that services meet the needs of patients and their families and that services are provided to the highest of standards”.

Also speaking in the Dáil, Health Minister Stephen Donnelly thanked Dr Finnerty for her work in compiling the report. He also noted “the very important work, the good work, done by CAMHS teams right across the country”.

“I want to thank them for their ongoing commitment to young people and families. And it’s important to emphasise that a lot of young people experienced a positive outcome with the support of our Children and Adolescent Mental Health Services.

“It’s important for us to reflect that while the interim report was quite rightly calling out the things that need to change, it also makes some very important points about what is working.

It references 225,000 appointments that took place last year under these services, 21,000 young people are being supported by our Children and Adolescent Mental Health Services.

“And critically, the interim report notes that many young people and their families have received and, I quote, excellent care and treatment. We need to keep that in mind.

“Acknowledging the serious concerns in the report, I’d like to remind all those using CAMHS on their families that HSELive is available to support any children, young people and families with concerns arising from the interim report,” Donnelly said.

HSELive’s freephone service can be reached by calling 1800-700-700; Monday to Friday 8am to 8pm and Saturday to Sunday 9am to 5pm.

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