Peter Fitzpatrick (Louth, Independent) | Oireachtas source

Last week, I spoke with a father pleading for sufficient care for his daughter's mental health. Thankfully, we got a bed for his daughter with the help of the Minister of State, Deputy Butler, and her team. However, this is just one of hundreds of children's stories and it highlights the lack of services available for child mental health services in my constituency of Louth-East Meath.

A lack of emergency CAMHS out-of-hours services is resulting in 16-year-old children presenting in accident and emergency. If they are lucky enough to speak with a CAMHS psychologist, they are commonly recommended for residential care. However, residential care is not available on an emergency basis and children have to wait until a bed becomes available. They are being passed from pillar to post. On top of this, when a child attends accident and emergency, if they are under 16, they are referred directly to CAMHS, but if they are 16, they are considered an adult and are admitted to an adult ward. The main issue here is that despite being eligible for an adult ward, they are not eligible to access the psychological doctor in Our Lady of Lourdes Hospital as that is for adults only.

This is highly contradictory yet is likely to be related to the skills gap and staffing issues I have raised in the House previously. There is a staffing shortage both in terms of consultants and in all of the therapies that are an essential part of the services. Skills gaps in teams and among the clinicians in posts that have not been prioritised have led to the CHOs having a lack of control as to the services they can provide. It seems that it has become very specialised. I often think that when services are in crisis, they get into the habit of turning cases away if they do not fit into a narrow definition of the conditions to which they are going to respond. In fact, having suicidal ideation will not guarantee access to CAMHS and, in some cases, having a disability will mean a child is likely to be diverted elsewhere.

The CHO 8 area, which includes Louth and Meath, has the second longest waiting list for these services in the country. There are 617 young people waiting for urgent attention from CAMHS and, worryingly, 245 of those have been waiting more than six months, with over 70 waiting over a year for care. I have constantly raised the issues of CAMHS waiting lists and lack of services on the floor of this House in relation to County Louth and east Meath. I have questioned why the HSE has not been able to fill an intellectual disability consultant post in the Child and Adolescent Mental Health Services in Louth and Meath and asked when one would be appointed. I raised this issue because I am aware of at least 15 families who have adolescent children with autism or moderate learning disabilities who urgently require a review. In addition to psychiatrists not being available, CAMHS will not see teenagers who have a dual diagnosis, and these adolescent children cannot be seen by the mental health team until they are 18 years old. Where are they to go to be seen?

Young people's mental health issues are escalating and becoming much more acute because they are not able to access preventative early intervention. Every child who uses mental health services has the right to appropriate care and support. Due to unacceptable waiting lists and a substandard level of care, many children are being denied this right. Most parents I speak to are just trying to focus on getting help for their son or daughter and they do not have the energy afterwards to advocate. This is why, on the back of the publication of the interim report by the Mental Health Commission into CAMHS, I and my colleagues in the Regional Group called on the Minister for Health to outline the immediate steps being taken to protect children and to ensure proper access to the Child and Adolescent Mental Health Services.

I acknowledge that the new clinical leadership, especially the appointment of an assistant national director, will ensure governance, consistency and integration across mental health services. However, we need consultants and all of the therapies that are an essential part of mental health services. We need to ensure that hiring is done quickly. We need to ensure that psychiatrists are trained to work with children and trained in risk management, clinical governance and paper-based record-keeping as these are major faults highlighted at present. We have the highest rate of youth suicide in Europe. We cannot afford to wait on more reports to act; the HSE and the Government must act now.

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