Michael Harty (Clare, Independent) | Oireachtas source

As the Minister of State knows, the child and adolescent mental health services, CAMHS, are extremely important. Unfortunately, they are under-coordinated and under-resourced. As many other speakers have said, early intervention is the key, preventing escalation to more serious mental health issues. Intervention may not only involve the individual but may also involve the family, so there are wider issues in regard to adolescent mental health services.

As I said, early intervention is the key and the main intervention is talk therapy, counselling and psychological intervention. As Deputy Wallace said, there is a tendency to the overuse of medication. If one is waiting months or years for treatment, the temptation is to medicate, which is perhaps not in the best interest of the patients. It must be kept in mind that this is due to the difficulty in accessing talk and counselling services. If medication is prescribed, which may be necessary, it should be for the shortest possible time to prevent overdependence on medication. Early access is the key.

The current issues in regard to young people are lack of self-confidence, lack of self-esteem, low mood and low motivation, which carries through into poor school performance. Bullying and peer pressure in school can put severe pressure on individuals. There is also the issue of sexual awareness, social media issues caused by social pressure, the issue of body image which can also be part of social media issues, domestic issues and family breakdown, homelessness and drug and alcohol abuse which unfortunately can be serious issues in adolescence. These are all issues which need to be addressed but they can most commonly be addressed through counselling and talk therapy within primary care and do not necessitate referral to psychiatrists. Psychiatry should be the last resort for adolescent mental health issues.

The other issue is the CAMHS teams, which are under-resourced. Many CAMHS teams are missing vital components. Social workers are very important in CAMHS teams, as are counselling, psychotherapy and, of course, the psychiatrists themselves. The national youth mental health services task force reported some two years ago with many recommendations. One of the recommendations was for a national lead in youth mental health and to have a youth mental health lead in each CHO area. I wonder what progress has been made in that regard. There was also a proposal to set up an interdepartmental team, Pathfinder, which would oversee mental health policy and prioritise youth mental health initiatives. What progress has been made in those areas?

Overall, we must have early intervention and the co-ordination of our voluntary and community sector with our health services. If there is better co-ordination, we will reduce waiting lists and improve early intervention.

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