Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I thank Deputies Cullinane and Ward for bringing forward the Bill and acknowledge the work of Deputy Ward in the field of young persons' mental health over recent years.

The Mental Health Commission's report into CAMHS highlighted a multitude of concerning issues on which we have seen too little action from this Government. To list some of the issues highlighted, we have seen children being lost to follow-up care or unable to access care in the first place, a lack of monitoring of psychiatric medicines and unacceptable waiting times for high-risk referrals among many other issues. To call this scandalous is, quite frankly, an understatement. The reality of this is not news to those directly impacted or to their families. They know the pain, the fear and the concern that this crisis in CAMHS has caused them as they try to navigate a system that is failing and collapsing at an impossibly difficult moment in their lives. The fact that families have to come begging and pleading to local representatives is an absolute disgrace and an indictment of a system that is beyond failure. We are losing people because of this. The Minister of State knows this, as does every Member of this House.

The statistics speak for themselves. Waiting lists for first-time appointments for CAMHS have skyrocketed by 83%, with certain CHOs experiencing an alarming threefold increase since this Government assumed office. Even more distressing is the nearly 300% surge in the number of children waiting longer than a year for a first-time appointment. This statistic is not only unacceptable, but deeply concerning given how important early intervention is in the field of mental health. We cannot afford to ignore the consequences of this inaction, which is why this Bill is so timely and prescient.

Mental health issues among young people are complex and multifaceted. Just about every study conducted says the prevalence of these issues is growing and that their impact is exceeding projections. The figures we have prove this. These issues require prompt intervention and comprehensive support rather than increased waiting lists and increased isolation. Every day that passes without proper assistance exacerbates the suffering for our children. This is not an issue the Government can just kick down the road. Our children cannot wait any longer.

In her opening statement, the Minister of State, Deputy Naughton, mentioned the mental health Bill that is to come in the summer term. We will hear more about it in the Minister of State, Deputy Butler's closing statement. In that statement, the Chief Whip mentioned that the summer term begins in April. However, in recent summers, we have seen it promised that Bills, particularly health Bills, will come before us in April only for them to be introduced in the last week of July. They are then debated well into the autumn and, if any progress is made, it is well into the following year. We know the clock is ticking on the lifetime of this Government and this Dáil. If the Minister of State's Bill is going to stand any chance, it must be presented in the first week of the summer term.

By granting statutory powers to the Mental Health Commission to regulate CAMHS and implementing the recommendations outlined in the commission's report, we can have the opportunity to effect real and meaningful change. If passed, this Bill would give the commission statutory powers to oversee and implement the remainder of the 49 recommendations. The Bill would not only ensure accountability and oversight, but would also facilitate the implementation of central governance and clinical reform, which are long overdue.

An issue within these services that such regulation could address is the treatment of people with autism, an issue highlighted by a previous speaker. Simply put, the system is failing them as well. CAMHS operational guidelines set out that admission to services can be refused to autistic children where there is an absence of a moderate to severe mental disorder. Where there is such a disorder, it is the role of CAMHS "to provide appropriate multidisciplinary mental health assessment and treatment". However, we are frequently not seeing care provided even where such a disorder is present. Many families are facing this barrier and we feel that children with autism are being frozen out of the system and denied treatment. The responsibility is passed on to someone else rather than CAMHS trying to tackle more complex issues.

One of the biggest indicators that the State is failing in its responsibility to provide adequate medical care for its citizens is those citizens having to fly abroad to get it. There have been countless cases of this in different areas over the years and we now see it in our mental health services. Parents of children with autism are travelling to the UK, Spain and other places to get care for their children. This is another example of absolute crisis and failure. Parents should not be expected to fight and to go to such lengths to get basic supports and rights for their children. They should not have to fight at all. Every issue children have within the entire spectrum of mental health needs to be looked at and those children need to be cared for and processed locally in the community.

When children with autism present, everything seems to get linked to their autism. It is a cop-out by the mental health services. If I go to the doctor seeking a prescription for hay fever medication, I do not expect to be told I do not need it because I have a stomach bug. The diagnoses are not related. The care we provide needs to be more responsive and more dynamic. This is something regulation can help with. If we keep putting people into a box and relating their every issue to that one other diagnosis, these young children will never get the care they so desperately need.

A change to the regulation of CAMHS would also provide an opportunity to ensure that people availing of these services are neither overmedicated nor undermedicated. A number of instances of overmedication in Kerry were revealed last year. The Maskey report stated that significant harm was caused to 46 children because of overprescribing by a junior doctor. Overmedication is extremely dangerous and can result in lifelong damage. That does not need to be restated but it is a fact. The overmedication and crisis in Kerry CAMHS sent shockwaves throughout the entire system and further weakened whatever little remaining confidence people had in the system, if they had any at all.

Ultimately, all the Government needs to do is to look at what the chief mental health inspector, Dr. Susan Finnerty, said in her report on CAMHS. If the chief mental health inspector cannot assure parents seeking a service's care for their children that it is safe, effective and evidence-based, that service is not working. It is failing and needs to be regulated. Dr. Finnerty outlined that a lack of clinical governance, ineffective leadership and inadequate resources meant that CAMHS was "creaking at the seams, with increasing risk to children for whom the service is provided." We and the Government know this to be the case and yet it refuses to support progressive legislation such as the Bill before it this evening.

The Government also has to acknowledge that the failure of the service is due to the lack of resourcing. The HSE has confirmed that, of the 72 registered CAMHS inpatient beds in the State, only 51 are operational. As of October last year, 30 were occupied. The main reason for this is staff shortages. There can be no excuse for this. Every time we bring up funding, the Government states that it is providing record funding and that the health budget is the biggest in the history of the State. However, it is not getting to where services are needed and it is not resulting in the staff required to meet basic service requirements such as ensuring that the registered beds we have are operational.

With 22,000 children being referred to CAMHS per year, there should be no surprise within the Government that the service needs proper support with regard to both staffing and funding. Upcoming generations face enough hardship and uncertainty already. They do not need a service that is meant to be there for them when they are at their lowest to have collapsed. I ask the Ministers of State to think about what the young people of today have to protest. They live in a country where the chances of them owning a home before they are 40 are terribly low. In fact, the chances of them accessing a home in any way before they are 40 are terribly low. They know from the generations just above them that moving across the water or emigrating is an option they will have to consider. They are facing a world of increasing insecurity and the impact of climate change is felt more keenly among the younger generations than among the generations above them that caused the climate disaster. Our children deserve better. They deserve a mental health system that is responsive, accessible and effective. Today could be the first step in achieving that if the political will was there. There is no excuse for not regulating CAMHS or for pushing it into the summer. Members of the parties in government have called for just what is being offered today. Along with the entire Government, those Members should put their votes where their words have been. The Government should withdraw its amendment and support this Bill today.

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