Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

From almost two years, our lives have been on pause. We have all been in a kind of limbo and it has been exceptionally difficult. However, for children and young people, this pause has had an especially profound effect. While milestones were missed and the freedom to play and socialise was severely curbed, the crisis in youth mental health accelerated. In fact, it is now at a serious crisis point. Last year, almost 12,000 children and teenagers were referred again or were newly referred to CAMHS community teams. Some 3,357 of them were still waiting to access CAMHS by the end of November. According to the HSE, 1,686 of them were expected to be seen within three months, while the wait time for the remaining 1,671 was completely unknown. There is no plan there to manage the waiting lists. It has been said that having a mental health issue is not like having a broken toe or something like that. A young person with a serious mental health issue needs attention fairly urgently. The idea that more than half of the young people waiting for services have been waiting more than three months, and many of them for much longer than that, is an absolute scandal. We have to face up to it.

We know early intervention is of the utmost importance. All the professionals say early intervention is critical, before the situation becomes much more serious. The kind of numbers I mentioned just cannot be tolerated. While we all appreciate the pandemic and the cyberattack had an impact on all waiting lists, we know the problems in CAMHS predate both of them. For years, these waiting lists have been stubbornly stuck at at least 2,500. That is standard. In some cases, the lists were even longer than that. We cannot make excuses that it was the pandemic or the cyberattack. There is a systemic problem there. Staff shortages, a rise in demand and poor geographical coverage have created a perfect storm, forcing children to desperately seek help in emergency departments, which is probably the worst place they could go. There is simply nowhere else for them to go. According to Children's Health Ireland, CHI, attendances at emergency departments for mental health issues jumped by an incredible 58% over the second half of 2020 compared with the same period the previous year. There is a clear indication the system is fundamentally broken when we have that level of increase in young people desperately needing help and support, and attendance at emergency departments rises by almost 60%. Even when children do attend emergency departments, we know most departments do not provide any assistance. They might keep a patient in for a while but no referral is made. There is certainly no out-of-hours referral for people who find themselves in a crisis. When a young person is brought to an emergency department, it is an absolute crisis. Unfortunately, it seems the country has nothing to offer them in those circumstances. That is the reality for so many young people.

We know that this situation is replicated throughout the country. Some areas are worse hit than others. For many years it has been obvious there is something very wrong in how funding for community psychology services in particular is balanced, or not balanced, and managed across the State. In September 2021, for example, those in community healthcare organisation, CHO, 3, CHO 4 and CHO 8 accounted for 85% of the children waiting more than a year for CAMHS appointments. There is a systems problem there. This raises a point I bring up on regularly, which is very important and is highlighted in Sláintecare, namely, that an objective resource allocation model must be pursued. We cannot continue with the practice of allocating resources to whoever shouts the loudest or to an area that is represented by a Minister in government. Resources have to be allocated on the basis of objective measurement. That is why we need the regionalisation of the HSE. We need to know what is actually happening and the level of demand for services in different areas. Nowhere is that more necessary than in youth mental health services.

In CHO 9, which is my own area and includes the communities of Ballymun, Finglas and Blanchardstown, areas of high need, 66% of children have been waiting for more than three months for an appointment. I ask the Minister of State to imagine being a parent in that situation with a child in crisis and having to wait more than three months to get an appointment. It is shocking. We are very much failing these children. What is even worse is the true scale of the crisis is not even fully reflected in the figures. For the countless children and teens growing up in areas where precursors to marginalisation already existed, the situation is far worse. They are at the sharp end of the crisis.

Last year, in my own constituency in Finglas, the Finglas child and family support network published a report that highlighted the considerable impact of Covid-19 on young people locally. It found many young people had lost sight of what was normal between not being able to go to school, see their friends, take part in sports and hobbies or attend youth clubs, not to mention, of course, the challenges many families faced to pay bills and simply to put food on the table. Several professionals working on the ground in Finglas reported that boredom and isolation had led to increased levels of antisocial behaviour and membership of gangs among children as young as 12. It will certainly be an uphill battle to address these types of behaviours. However, one thing is for certain: our approach has to be trauma-informed. The report also flagged concerns about the impact of school closures, especially in instances where school was the only thing providing any sort of structure and consistency in a child's life.

This leads me to the ongoing leaving certificate debacle and the effect it is having on young people throughout the country. It is unconscionable we are having the same conversations for the third year in a row.

This year's leaving certificate students have lived in flux for two years, constantly uncertain and confused about the manner in which their exams will take place, as if the leaving certificate was not stressful enough already. A 2019 survey of almost 2,700 students found that 75% of leaving certificate students reported suffering extreme stress over the course of the two-year cycle, anxiety being the chief issue for 71%. This was before Covid wreaked havoc on the State exams and the lives of children. We must accept that running the gauntlet of the leaving certificate is harming our young people's mental health. Meaningful and long-term reform is needed to remove the burden of stress and anxiety built into the traditional model. It is a relic of the past no longer fit for purpose, particularly in a world that is arguably more difficult to navigate than the one many of us grew up in.

This generation of children and young people are the most digitally connected but a CyberSafeKids survey published last September found that 84% of Irish pre-teens between the ages of eight and 12 use at least one social media platform. The research also shows that 93% of pre-teens have some kind of phone, tablet or other smart device. It is clear we as legislators and policymakers are failing to keep up with this pace of change. Young people are digital natives while we are still learning the new language of technology, or at least many of us are. Despite the ease with which they use technology, it does not mean they inherently possess anything like the skills needed for safe and healthy use, especially when social media giants are preying on their insecurities. An investigation last year by The Wall Street Journalinto internal research by Instagram's parent company, Facebook, showed worrying links between Instagram use and depression in teenage girls. There is a litany of information that shows the very negative impact many social media platforms have on young people. There is a combination of issues, not least of which is the impact of the past two years. We cannot continue with a system that is not fit for purpose. The Taoiseach said it himself this morning. There are systemic failures and we have to address them as a matter of urgency.

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