Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

Mental health services prior to Covid-19 were in crisis but it is now an emergency situation. The child and adolescent mental health services and Jigsaw both report an increase in demand of over 40%. Similar increases are relayed to me by community and voluntary organisations working in this area in Cavan and Monaghan. There is an over-reliance on community and voluntary services, with the HSE routinely signposting people while neglecting to increase their funding or not providing funding at all to some organisations.

Poor geographic coverage, a chronic staff shortage, and the fact most CAMHS services still operate from 9 to 5, Monday to Friday have led to long waiting lists and to children with complex needs unable to access timely support. One child with anxiety returning to school after the lockdown this time last year was referred by his GP to CAMHS. The services dithered about whose responsibility it was to see this child. This went on for months, with the child’s anxiety worsening all the time before the child was finally admitted into their services, I believe in September. It was from April until September before he was admitted into their services. That caused a build-up of anxiety and waiting time.

Young people have missed so much in the past two years, with many of the services they frequent drastically reduced or closed altogether. These services need to be expanded and better resourced.

Mental health services still rely heavily on the medical model and this does not align with the public health and the psychosocial support approach underpinned in the United Nations Convention on the Rights of the Child.

A child with a diagnosis of autism is being refused access to mental health services. What is that about? I am hearing from parents who are not informing CAMHS their child has autism because they will not be seen. The child cannot then get the proper treatment because the services do not know everything about that child that they need to know. The rate of suicide among adults with autism is higher in society than among those who do not have this condition. Suicidal ideation among children with autism is also regular.

I also want to highlight the lacuna that was pointed out by the Mental Health Commission between the heads of the Bills to reform the Mental Health Act and the Assisted Decision Making (Capacity) Act. The mental health Bill is set to provide for 16- and 17-year-olds to give or withdraw consent to treatment in mental health service if they are deemed to have capacity. The heads of the Bill state the Assisted Decision Making (Capacity) Act would apply for the purpose of conducting the necessary capacity assessment. However, the Act does not provide for decision supports for those under 18 years of age. This needs to be addressed promptly because the Assisted Decision Making (Capacity) Act is vital for the ratification of the optional protocol of the United Nations Convention on Rights of Persons with Disabilities.

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