Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank the Senator for raising this important issue in mental health services. I welcome any campaign that deals with stigma.

On the issue raised by the Senator, the HSE service plan for 2019 commits to developing all aspects of child and adolescent mental health services, CAMHS. This includes developing a seven-day per week service for CAMHS to ensure improved support for vulnerable young people, as well as related initiatives in enhanced early intervention and day hospital care. Community based CAMHS teams provide specialist mental health services for young people up to the age of 18 years and operate on a five-day per week basis. Expanded CAMHS provision will be in line with adult services where a seven-day service is being developed.

Where a child has a mental health crisis, the initial consultation should be with the child's general practitioner, GP, and if the GP assesses that the child requires an urgent mental health assessment, the GP should contact the local CAMHS team. Where a person under 18 years of age presents to an emergency department following self-harm, it is important that he or she receive a compassionate and empathic response. He or she should receive a bio-psychosocial assessment from a suitably qualified mental health professional prior to discharge from hospital. It is recommended that children under 16 years of age be admitted overnight to a paediatric ward. The paediatric team should ensure the child receives a bio-psychosocial assessment prior to discharge from hospital, thus following international best practice. In some hospitals the child will be assessed by a non-consultant hospital doctor, NCHD, who can discuss the case with the on-call CAMHS consultant. In other services, there might be no on-call CAMHS consultant and the paediatric team will be advised to wait until the CAMHS consultant is available.

The HSE national clinical programme for the assessment and management of patients presenting to an emergency department following self-harm aims to ensure all such patients receive a bio-psychosocial assessment. The programme is being extended to include the three paediatric hospitals in Dublin. Three clinical nurse specialists, one for each of the three Dublin paediatric hospitals, are being recruited. The addition of a specialist in each of the hospitals will improve follow-up care. In addition, all three Dublin paediatric hospitals provide a comprehensive liaison psychiatry service. In Temple Street Hospital it is provided in conjunction with the local mental health service 24 hours a day, seven days a week. In Crumlin and Tallaght children's hospitals the liaison psychiatry service is available Monday to Friday, from 9 a.m. to 5 p.m. Outside these hours, children are assessed by paediatricians and admitted to a paediatric ward. In Cork University Hospital there is a liaison psychiatric nurse available Monday to Friday, from 9 a.m. to 5 p.m. This nurse is supported by a consultant from CAMHS. Outside these hours, a NCHD completes assessments and CAMHS consultants provide input, as appropriate.

CAMHS inpatient units currently operate a 24-7 tertiary model of care for young people with severe or complex mental health issues. There are 74 CAMHS inpatient beds in four units in Dublin, Cork and Galway. The new children’s hospital will have an additional 20 CAMHS beds. There will be ten CAMHS beds in the new forensic mental health complex which is due to open at Portrane next year. It will be the first such unit nationally.