Dr. Aileen Murtagh:

In terms of the physical environment, much work went into the planning and design of the current inpatient unit to make it a very adolescent-friendly environment and it is now a far nicer place in which to work. Many young people who come to the unit for the first time have very pre-conceived notions of what an inpatient unit looks like and most expect it to be very dull and dreary and contain straitjackets. They are quite surprised to see that it is bright and cheerful. Having worked in the public and independent sectors, I recognise that there are similarities between them. People who work on the front line with young people are extremely dedicated and do their best, often with very few resources. That is a definite similarity.

In my current post, my job is far easier and I have more time for front-line work with children and families. My colleagues highlighted issues such as administrative deficits. I have not opened a door, written a letter or had to listen to an answering machine since I started in my current post because there is excellent administrative support and cover for leave. Such things make a huge difference. If that support was not available, I might have to check the answering machine three or four times a day, which is fine but means an hour of my clinical time is spent answering a phone rather than providing emergency assessment to a young person, for example. The training of nurses and allied heath professionals is very much supported.

The issue of recruitment and candidates not matching the required skill set was mentioned. Allied health professionals in the HSE are recruited from a panel. If a position becomes available, such as a senior clinical psychology post in adult mental health services, and the geographical location of the job suits the person at the top of the panel, because there is no clarity on when or where the next job may be he or she might accept the post even if he or she has no training in adult psychiatry and had been working in CAMHS for seven years. Such a recruit might stay in the adult service for two or three years until another post became available in CAMHS. In St. Patrick's there is a specific advertisement and a candidate whose skill set specifically matches the needs of the young people and the service is recruited.