James Browne (Wexford, Fianna Fail) | Oireachtas source

I am sharing time with Deputy Rabbitte. Perhaps the Minister of State's speech could be made available to Members.

I welcome the opportunity to speak on this very important issue of CAMHS. I thank the Ceann Comhairle for arranging this debate and for his continued work in highlighting mental health issues.

Demand for acute CAMHS is increasing. More than 2,500 children are now waiting for a first appointment. Almost 300 of them have been waiting more than a year for first assessments. This is an intolerable wait for children to see specialists. It is a scandal that children and young people are waiting so long for treatment. The failure to give people with mental illnesses the timely help they need is irreparably damaging their lives. Long waits for access to necessary mental health supports can be deeply distressing for people. From childhood to later life, it is vital that mental health support is available for children and young people and their families. I want to put these waiting times into context. In the UK, there is a new guaranteed maximum four-week waiting time for children with more complex problems to access National Health Service, NHS, CAMHS. Recently, there was outrage in Scotland that delays for access to CAMHS had extended to 18 weeks. In Ireland, the wait can be over 12 months.

Why are our CAMHS in such short supply? There are a number of reasons, but they are ultimately caused by the Government's failure to prioritise children’s mental health. There are a significant number of child psychiatrist vacancies. For example, a child psychiatrist travels to Wexford from Galway every weekend to provide cover because for the past six months there has been no child psychiatrist in Wexford, which has a population of 150,000. The conditions within which the CAMHS staff work in are horrific. They are so bad, they in part led to the last child psychiatrist in Wexford leaving. There have been endless false promises about a new facility. The situation is regrettably similar in many other parts of the country.

There are shocking waiting times for primary care psychology. Again, taking my county of Wexford as an example, the wait is three years and no urgent cases are being seen. This means that an opportunity is lost with mental health issues where there could have been an intervention at an early stage and a resolution found. Instead the issue goes untreated and may progress to a more serious issue, necessitating CAMHS intervention which ultimately puts more pressure on CAMHS.

The Government has failed to roll out Jigsaw nationwide. It is an absolute scandal that non-qualified specialists are working as consultant psychiatrists. Children are still being admitted to adult wards in breach of their human rights because there are not sufficient beds in the system. Many of the beds that are there are not operational throughout the year. Children with autism cannot get the mental health care they need. Only 12 whole-time equivalent staff in the whole country work in the mental health disability sector.

As a result of the confidence and supply agreement, an extra €55 million was made available for mental health services and new initiatives in the budget. However, the Government spent almost that amount on agency staff last year.

Whenever the Department was challenged about long waiting lists last year, we were told not to be complaining because there were going to be an additional 4,000 referrals to CAMHS, an increase of 40%. Anyone with the most basic knowledge of CAMHS knew this was a farcical promise. The latter proved to be the case, with only a little over 10,000 people seen - an almost identical number to the year before. Thankfully, that promise is not being repeated this year.

Psychiatric nurses are escalating their industrial action and they have our strong support. They are voting with their feet. The number of vacancies in psychiatric nursing has increased by 40% since 2017. Psychiatric nurses are overworked and highly stressed and the facilities in which they operate are understaffed. Their own mental health is under strain. The Minister needs to engage with them.

Children and young people's mental health is clearly not a priority. What do we know about young people and their mental health? We know that approximately half of all mental illness starts before the age of 14 and therefore it is critical that children get the mental health supports they need as soon as they need it. We know that if we catch mental illness early we can treat it and prevent it turning into something more serious. We know there is a crisis in young people’s mental health. There is a crisis with those young people accessing mental health care. Many vulnerable children under the age of 18, including some who may be suicidal, are being forced to wait unfairly for the care they need and deserve, or are being denied care because CAMHS are overloaded. Our children are being let down.

We also know that with timely and appropriate intervention our children can recover. What are the consequences of the Government’s failure to provide appropriate and timely mental health care for our children? The first obvious point is that they get worse. Like any physical illness left untreated, a mental illness worsens without intervention. This means that when intervention is provided, if it is provided, the condition has become more ingrained, the treatment required is more severe and the recovery period is significantly longer.

While all this has been happening, very often a child’s well-being will have spiralled downwards. His or her ability to participate in society will have been impacted. He or she may find school difficult and may drop out or face expulsion. He or she may become susceptible to criminal gangs that seek to take advantage of his or her vulnerability. He or she may end up in prison or, worse, take his or her own life. Fundamentally, children are being denied their basic human rights to health care so that they can recover and live healthy empowered lives.

None of this is necessary. The Government needs to take urgent action to address the crisis in CAMHS. There are solutions and our children can recover, but this will only happen if their recovery is prioritised. Unfortunately, there is little sign of this happening.

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