Oireachtas Joint and Select Committees
Thursday, 12 November 2015
Joint Oireachtas Committee on Health and Children
Child and Infant Mental Health: Discussion
I welcome the presentations from the attendees. With regard to investment, we have been informed that €35 million extra has been invested each year, except for one year when €25 million was put in, over the past five years. That represents an increase next year of €165 million extra every year, as recruited people must be paid every year and introduced services must be provided every year. It is not as simple as having €35 million and giving another €35 million. There will have been €165 million put in after the last budget. Every time we ask questions on the number of people recruited, we are told there are difficulties relating to access. We want to recruit approximately 1,100 people into the area, including CAMHS. People have mentioned that some of the investment has gone into CAMHS so perhaps we can get a handle on what developments have taken place because of the investment.
There is a difficulty in that beds are vacant while children are in adult facilities. It is a real difficulty. I come from Limerick and if somebody there needs child inpatient care, the family must go outside the area. Parents are often inclined to say that they want to visit their child every day and cannot do it if the child is in Dublin, Cork or Galway. The same applies for Donegal. How does somebody in Donegal visit a child of four, five, six, eight, ten or 12 in a hospital when a parent feels his or her presence is very important to the child's recovery because of their relationship?
The witnesses spoke about out-of-hours services but going back ten years, there were no out-of-hours services for anybody. There is a level of service now. Is it still confined to 8 a.m. to 5 p.m. on weekdays? There are certain areas that have expanded the service to weekends. What level of out-of-hours services are there now for child and adolescent psychiatric services? With regard to self-harm, we know the largest cohort of females is in those aged 15 to 20, and for men it is for those aged between 20 and 25. It is a young person's issue. Each year, there are approximately 1,100 admissions to accident and emergency services related to this. Two eminent people are involved in the area, Professor Ella Arensman, president of the International Association for Suicide Prevention and director of the National Suicide Research Foundation in Cork and Professor Keith Hawton in Oxford, and they have stated that for every person who attends a psychiatric unit having self-harmed, there are at least eight who do not attend. Those people either go to their doctor or, because of stigma, which is another issue, conceal it within the family. Some do not even report it. If we are to extrapolate from those expert figures, it means more than 60,000 people of all ages are self-harming every year although it is predominantly a young person's issue.
We are still severely under-resourced in mental health services, going back decades or perhaps centuries. We still have less than 6% of the total health budget going to mental health services. England and Scotland put 13% of the budget into these services and Wales puts in 18% of its budget. We have a big hill to climb in providing proper mental health services for children and adults in this country.