Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Senator for raising this matter. I am delighted to be in the Seanad to discuss the issue of CAMHS waiting lists in the Senator's community healthcare organisation, CHO, and nationally because it is something on which I have put a huge focus. The Government and I remain committed to the development of all aspects of mental health services. As the Senator will be aware, the mental health budget for 2023 is in excess of €1.2 billion, which is another record budget for mental health services, and a continued focus will be on reducing waiting lists for CAMHS and primary care psychology services.

The CAMHS waiting list nationally was 2,755 in December 2020. It increased to 3,556 in December 2021 and, unfortunately, as of October this year, the provisional figure was 4,043, of which 398, or approximately 10% of the national waiting list, were in CHO 3, which covers the Limerick area. This figure is a slight increase on the same period last year, which was 355.

In the past year, we have seen an unprecedented number of referrals presenting to CAMHS all over the country. There were 25% more referrals last year than any previous year. We saw a huge spike in the number of young people presenting with eating disorders, with 504 entering the clinical programmes last year. When this programme was devised in 2016-17, they expected approximately 60 children would be referred.

Many children get referred to CAMHS but they do not all meet the criteria. Only 2% of children who are referred need CAMHS supports, with others, for example, needing supports provided by primary care psychology services, community teams and the National Educational Psychological Service, NEPS. It is important to note that the CAMHS waiting list can relate to capacities in other parts of the system where young people may not receive early intervention and their needs may escalate requiring referral to CAMHS. Access to the CAMHS system is based on a clinical assessment, with urgent cases being prioritised. Data made available to the Department of Health indicates that the mid-west CHO, encompassing Limerick city and county, has the fifth lowest waiting list for CAMHS services, as the Senator said.

The CAMHS service in the mid-west CHO is currently provided by six consultant child psychiatrist-led multidisciplinary teams. There is a seventh team, as the Senator said, in development that will facilitate additional capacity for service provision and a welcome, more timely response to referrals. Over recent months, significant progress has been made in recruiting for the filling of existing vacancies and new development posts. However, there are ongoing issues with recruitment in particular disciplines, especially consultant child psychiatrists, which is an issue reflected nationally. Several other disciplines are also affected, including nursing and psychology. My priority is to improve access to CAMHS and reduce waiting lists. As the Senator said, what else can we do? It will include measures such as better links with primary care or disability services and greater use of e-mental health responses.One of the CAMHS e-mental health sites nationally is identified for CHO 3 and the Limerick area. This will be very welcome. Referrals to CAMHS inpatient beds may not be appropriate in some instances where other options, such as CAMHS community teams, may be more suitable and effective. Each referral to an inpatient bed is triaged and assessed for overall need through a weekly teams conference of all four inpatient units.

Regarding the waiting lists, I have placed great focus on this aspect and secured funding to try to reduce it. Working through the HSE, we have contacted the various CHOs to see what they can do. We did this in primary care psychology. We targeted the waiting lists of over 12 months first, because these are the children needing these services the most. Unfortunately, when a priority case comes in, children who may have milder needs get bumped down the list, and this is not what we want to see.