Fintan Warfield (Sinn Fein) | Oireachtas source

I welcome the Minister of State, Deputy Butler, to the House. I get the impression every time she attends the House that she is very passionate about this topic, which is quite refreshing. I wish her well. People speak about mental health and it may well be too black and white to say it is a generational issue; it is certainly not but people are now so open about whether they go to therapy. It is refreshing.

It has been clear for some time that mental health services in this country are over-stretched. The publication of the look-back review of the south Kerry child and adolescent mental health service, CAMHS, which uncovered significant malpractice, is an appropriate moment to examine the failings across CAMHS, as well as wider non-acute health services for children. I welcome the debate in the Chamber and again I thank the Minister of State for always making time to come here.

There are 71,000 children waiting for life-changing treatment across occupational therapy, physiotherapy, speech and language therapy, dietetics, psychology and mental health services. An agenda for change is required in children's mental health services focusing on the filling of vacancies, for example, which has been mentioned numerous times, and addressing the causes of vacancies, including those that led to the situation in south Kerry and which could lead to worse. They have already led to similar malpractice in other parts of the State.

Following the review of south Kerry CAMHS, it was found that 240 children received substandard care and were exposed to unnecessary risk of significant harm by their misdiagnosis or poor treatment. Of those, 46 suffered significant harm, 13 were across other doctors and 227 related to a single doctor. The review found unreliable diagnoses, inappropriate prescriptions and poor monitoring of treatment, as well as poor monitoring of treatment and potential adverse effects, which led to a recommendation of a fundamental review of services across the State. The Taoiseach confirmed there will be a full nationwide audit of compliance with CAMHS. Meanwhile, the initial whistleblower, Dr. Sharma, recently left the service, feeling pushed out after being reassigned to administrative duties following his complaints, which led to the review. He felt the review was too limited in scope.

We need to protect children's mental health and fix our mental health services. We need to immediately put in place supports for children and families affected in south Kerry and to broaden the CAMHS review across the State. Some of what the Minister of State indicated in her comments is news to me. I note she requested that the HSE would commission an independent nationwide audit of compliance with existing CAMHS operational guidelines by all CAMHS teams immediately. She indicated there are ongoing discussions on the independently led prescribing audit for each of the CAMHS teams, which she sought as additional action beyond the recommendations set out in the report. I welcome that.

There are significant workforce challenges in psychology, as has been mentioned today, as there are insufficient numbers of graduates to fill the posts. My colleague, Deputy Mark Ward, called for a plan to address that major shortage of psychology staff in CAMHS. There are figures released from the Psychological Society of Ireland indicating a deficit of 98 psychologists in CAMHS, based on recommendations from Sharing the Vision from 2006. Representatives of psychologists have been warning successive Governments for years of the shortcomings in public psychologist numbers. A review into CAMHS is welcome but we need action to address these shortcomings and vacancies.

I also want to raise something that has not yet been brought up, which is the need for a review into the treatment of the south Kerry CAMHS whistleblower and the circumstances around his change in duties, which led to his resignation from the service. As soon as he was appointed, he saw the problems and he must be credited by this House for acting on them. His treatment as a whistleblower should be acknowledged and a review of that should be published. He resigned because he felt his position undermined and that must be examined.

I thank Mental Health Reform for the briefing document it shared with the Oireachtas. It is a reminder that on Mental Health Day 2018, I co-signed a Bill put forward by my former colleague, Ms Máire Devine, about the ability of 16-year-olds and 17-year-olds to consent or refuse treatment. I will not go into it but the Minister of State knows it well. As I am out of time I thank the Minister of State for coming here today. I appreciate the time she always gives to the Seanad.