Mark Ward (Dublin Mid West, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann: acknowledges:

— the commitment, dedication and hard work of staff within the Child and Adolescent Mental Health Services (CAMHS), children's health services and organisations that prioritise the mental health of young people;

— the work of the Mental Health Commission in reviewing CAMHS cases, and in publishing the interim report;

notes that:

— the Minister for Health, Stephen Donnelly TD, and Minister of State at the Department of Health, Mary Butler TD, have allowed the waiting list for CAMHS to increase by 86 per cent since the formation of the Government in June 2020, with the number of children waiting longer than a year for a CAMHS appointment increasing by 168 per cent;

— there has been a significant reduction of inpatient capacity for CAMHS, resulting in more than 700 young people presenting to emergency departments in 2022;

— the Report on the Look-back Review into Child and Adolescent Mental Health Services County MHS Area A (Maskey Report), identified 240 children in South Kerry CAMHS who were put at risk, and of those 46 who were put at significant risk in the handling of their care;

— arising from the Maskey Report, a national audit of CAMHS was launched by both the Health Service Executive (HSE) and the Mental Health Commission;

— concerns were escalated to the HSE by the Mental Health Commission before the report was completed; and

— many children and young people with open cases have been lost to follow-up, with 140 "lost" cases in one team;

further notes that:

— recruitment and retention issues are affecting all aspects of the HSE workforce, including those working in mental health; and

— ineffective recruitment panel systems contribute to this staffing crisis; and

calls on the Government to:

— urgently set out a timeframe for how they intend to review all open cases across all CAMHS teams as recommended by the Mental Health Commission, with a particular focus on children and young people who have been lost to follow-up;

— implement immediate regulation of CAMHS under the Mental Health Act 2001, as a priority;

— support the Mental Health Commission in completing its review into CAMHS;

— reinstate a national Clinical Director for mental health to ensure accountability within mental health services;

— improve integration between primary care, disability services and CAMHS;

— set out a clear multiannual funding plan with which to give CAMHS autonomy in delivering quality care, and in the medium-term to extend the current CAMHS to include 18-25 year olds, to ensure that there is no "cliff edge" and no "lost" service users, and to link this new service in with adult mental health services for a smooth transition between both services;

— develop national standards for monitoring of antipsychotic medication;

— urgently implement a CAMHS waiting list reduction and management plan;

— commit necessary funding to prioritise the rapid modernisation of healthcare information systems, including individual health identifiers, an integrated waiting list management system, and a centralised referral system;

— develop a joined-up, proactive, and comprehensive health and social care workforce strategy, to increase education places and training opportunities between the Department of Health and the Department of Further and Higher Education, Research, Innovation and Science, the HSE, Regional Health Areas/Hospital Groups, and higher education institutions; and

— legislate to prevent young people from being admitted into adult psychiatric wards.

The Government has not tabled an amendment to our motion and, therefore, I presume it will not oppose the motion. This is a tactic I will address further in my closing remarks. Sinn Féin is more interested in providing solutions than playing politics, such as the solutions to the woeful neglect by successive governments in the failure of children's and young person's mental health services. Parents of young people will be watching who are desperately trying to get the proper mental health care for their children. There are a couple of parents I know in the Public Gallery to listen to us today.

I echo the Mental Health Commission report that states in some instances children and young people get excellent care from dedicated staff while under the care of the child and adolescent mental health services, CAMHS.

While this is true in some cases, it is the complete opposite for many families.

Sinn Féin's motion will ensure mental health services for children and young people are properly resourced and fully staffed and provide support when and where they are needed. The scandals in CAMHS were laid bare once more last week. The Government needs to act urgently to ensure we have services that are fit for purpose for our children and young people. Current services are not. There are serious concerns and risks for patients accessing CAMHS. This is a second report concerning children being placed at risk while under the care of CAMHS.

Where the Government has failed, Sinn Féin want to offer solutions. Early intervention is key. All children and young people deserve the opportunity to reach their full potential. Children and young people must have access to mental health services when and where they need them. Eligibility for services should be extended to 25 years of age to prevent children falling off a cliff edge at the age of 18. This was outlined in Sharing the Vision. The majority of acute long-term mental difficulties develop between the ages of 16 and our mental health services must reflect this. We are calling for multi-annual funding for CAMHS so it can operate and forward plan to be able to properly staff teams. We are calling for an integrated IT system to improve quality of care. It is 2023 and it shocking to the extreme that we do not have an integrated IT system for children and young people's mental health.

There is a fundamental need for greater accountability and oversight across the health service. We are calling for the reinstatement of the national director of mental health services in the HSE who would report directly to the CEO of the HSE and the Minister of the day. There has been no national director of mental health services since 2016, despite the current programme for Government containing a commitment to reinstate the position. The Minister has called for this but the HSE seems to be blocking this appointment. There seems to be a big disconnect between the Minister and the HSE. Who is in charge?

The Government must prioritise the recruitment of a youth mental health assistant director in the HSE, as promised in budget 2023. This post is essential to ensure leadership in the improvement of mental health services for children and young people but recruitment has yet to begin. Again, there is no urgency.

Sinn Féin wants to empower CAMHS to be able to respond to issues raised in the Mental Health Commission's interim report. I thank Dr. Susan Finnerty and the commission for publishing this report early. The report did not come as a shock to any family with experience of accessing CAMHS. They know too well that the Government has been failing young people as waiting lists have dramatically increased under its watch.

We must introduce national standards for monitoring anti-psychotic medication. We must develop a joined-up and comprehensive health and social care workforce strategy to increase educational places and training opportunities between the Departments of Health and Further and Higher Education, Research, Innovation and Science. We must increase undergraduate and postgraduate courses and training places for mental health professionals. Minimum staffing levels for CAMHS must be published so at least we have something to aim for.

Our mental health services are in crisis and we can do so much better. We owe it to our children and young people. Our young people deserve hope, solutions and mental health services that are fit for purpose. There is nothing worse than denying a child or young person every opportunity to reach his or her full potential.

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