Clare Daly (Dublin Fingal, Independent) | Oireachtas source

I am glad to be here to participate in the discussion. The comments I will make have been prepared for me by the excellent Emma Smith, a young transition year student, with whom we have had the pleasure of working in our offices during recent weeks. She makes the point that in discussing this matter we must start by recognising that CAMHS has been a vital source of aid for young people who struggle with a form of mental illness, a learning difficulty, a speech issue and so on, and also for their families. It is vital. The level of interest in the debate today shows that.

We must view CAMHS in the context that, thanks to years of austerity, it has been chronically underperforming. It is the young people and their families who are being put under an unbearable strain as a result of that situation. The numbers of people on waiting lists are scandalous. As of September 2018, we know 1,369 young people had been on the list for more than three months, 470 had been on it for more than six months, 241 had been on it for nine months, 222 had been on it for more than a year and so on. In my area, 46 vulnerable young people were left waiting for an appointment for more than six months. That is incredible and a cause for extreme concern. Six months is far too long to leave a young person to suffer, particularly because he or she is at a crucial stage of his or her development and any delay can and will have life-long consequences for him or her. Not only that, but with the services being in such catastrophic disarray, they were putting young people at serious risk. It has been said that 70 children under the age of 16 years died by suicide in Ireland last year. That is devastating. We, as a Parliament, must ask how can we standby and allow this to happen?

Waiting lists are inevitable when staff numbers have been dropping relentlessly. The services are only operating at roughly half the recommended number of full-time staff. We must be honest about that. The staff numbers in CAMHS are down for the same reason they are down in the Defence Forces and nursing, namely, because there is a recruitment and retention crisis. Years of cuts have resulted in staff being seriously overworked and overworked staff who have been kicked around by successive Governments for years do not tend to stick around if they can get out at all. Unfortunately, that is the situation we are in. The Government tells us we are out of the austerity woods but it fails to recognise the importance of the scars that have been left right across our public service. In this case, it is vulnerable children.

We know many regions in the country have next to no professionals. There are only 84 working to provide assessments and treatments for all of Laois, Offaly, Longford, Westmeath and Louth. Worse again, there are only 49 for Carlow, Kilkenny, Waterford, Wexford and south Tipperary, which have a population of nearly half a million people. The chronic understaffing has meant that children are being inappropriately admitted into adult mental health inpatient units. The fact that there were 82 admissions in 2017 is utterly shocking. I cannot imagine how devastating it must be for a child, particularly a sick and vulnerable child, to experience something like that. Worse again, we know that the low levels of staff are inadequately trained, and such inadequately trained staff in inpatient units means that seclusion and physical restraint are becoming normalised, which is an horrific prospect. Children suffering from a mental illness are getting no better treatment than in the Victorian asylums that operated in the past. For those children who are treated by CAMHS, care plans, individually formulated to suit the patient, are time and again overlooked despite the fact that all the evidence shows that these plans are the cornerstone of a successful recovery.

We need to address these shortfalls or an entire generation who so desperately require help and guidelines will be left behind. It is important we recognise that it is not about quantity over quality. Pressure on staff to get people through the system has become immense. A stress on numbers turns cases into quotas. It is no longer about helping a child adequately but instead it becomes about doing as little as possible for as many possible. That is not a solution. This is the institutionalisation of improper care. If the issues with CAMHS are not solved, it will go down as one of our country's biggest failures.

See this speech in context