Peter Fitzpatrick (Louth, Independent) | Oireachtas source

In the programme for government document Our Shared Future, published in 2021, 16 commitments were made to children and young people. While the Government made progress in areas such as online safety, affordable access to childcare and the school books scheme expansion during 2023, when it comes to mental health care and supports we continue to fall far short of what is required.

Children with a dual diagnosis of mental ill-health and an intellectual disability are falling through the cracks, as are neurodiverse children. A lack of emergency CAMHS out-of-hours services is resulting in 16-year-old children presenting in emergency departments. If they are lucky enough to speak with a CAMHS psychologist, they are commonly recommended residential care. However, residential care is not available on an emergency basis. 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 an emergency department, if they are under 16, they are referred directly to CAMHS but if they are aged 16, they are considered an adult and admitted to an adult ward. However, the issue in my constituency 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 service is for adults only.

The annual report of the Children's Right's Alliance, the umbrella body for approximately 150 organisations working with children, highlights this practice which needs to be addressed, as well as the unacceptable rise in waiting lists for CAMHS. Access needs to be increased and we can only do this through recruitment and funding, yet both have been stalled for health. The diminished funding for health in this year's budget means it is spread thinly across all Departments, with children losing out. Last week, a leading provider of intellectual disability and community mental health services in Louth, St. John of God Community Services, which works with approximately 8,000 children and adults, announced a decision to transfer its operations to the HSE because of unsustainable budgetary issues.

We discussed only last week the deplorable wait times for children with spina bifida and orthopaedic services due to funding and recruitment barriers. The HSE recruitment freeze no doubt has had a significant effect on wait times in children’s mental health services. For example, over the Christmas period, which is undeniably a hard period for many, GPs in County Louth received a letter informing them that there would be no consultant psychiatrist cover in the Elms CAMHS for the next four weeks, and so no action was taken on referrals received within this period. Elms is one of three teams that provides the main HSE child and adolescent psychiatric services for all of the county. Doctors were further advised to send any emergency psychiatric presentations of patients experiencing mental health crises to emergency departments.

Figures show there has been a significant increase in the number of young people waiting to be seen at CAMHS for first-time appointments in the HSE CHO 8 area covering County Louth, with the numbers almost tripling over the past three years. Figures increased past 4,400 in 2023. This cannot be allowed to continue. Re-referral rates for CAMHS are high, with some children and young people being referred two or three times for the same difficulties. It was also highlighted in the report that there were varying wait times for follow-up appointments, monitoring and prescriptions, with some children taking medication without appropriate blood tests and physical monitoring, which is essential when on medication.

These figures, which are not unique to my constituency, show a complete failure by the Government to prioritise young people's mental health care. The report of the Children's Rights Alliance found there were 72 beds in four public child inpatient units but just 51 of these beds were operational or available for admission and only 30 of those 51 operational beds were occupied. Fewer than 60% of the beds available for children with serious psychiatric illnesses are being used as a result of chronic staff shortages. This is of serious concern. It is essential that the Government does everything feasible to attract medical personnel to our mental health services. It needs to address the barriers to qualified people taking up employment in the system.

Children’s mental health services must be funded and regulated. The development of standards and rules for the provision of CAMHS community services across the State, as proposed in section 33 of the health (amendment) Bill is the first step in tackling the crisis in children's mental health and will lay the foundation to reduce waiting lists.

The Government is now faced with the question of what it wants to see happen for children and young people in the final year of this programme. It is troubling that children with mental health issues are being failed by the Government. Every day, children are suffering because of inadequate access to the care they need. There is an inconsistent continuity of care and many young people fall out of services or never access them at all. These failures mean that early intervention is passing young people by. Vulnerable children deserve better. They deserve timely access to the care and support they need to thrive. We need to listen to the voices of children, families and experts who have been advocating for change. Together, we can ensure that no child is left behind and that every child has the opportunity to grow up in a healthy and happy environment. The time for action is now.

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