Annie Hoey (Labour) | Oireachtas source

I thank Mental Health Reform for all its advocacy and the support it provides. I have been contacted by people for whom CAMHS has let them down or has not been right. I have also been contacted by parents where it has worked for their child. The system can work for some people. Unfortunately, we are not here to talk about those people but we are here to talk about the people for whom the system has not worked and who have been let down by the system.

I am sure in the trials and tribulations of our job, all of us were contacted about CAMHS before the publication of this report. I remember one case that really stood out and did not make sense to me. It was a trans adolescent who had an eating disorder. CAMHS in their area said it could not help. There were multiple issues. We tried to help and do what we could. The parents sometimes wondered if they had been living in a different area whether the CAMHS in that area would have been able to help. I occasionally think of that young person who would now be nearly in adulthood and how they got lost in the system because they were too complex for the system. We cannot let people fall through the cracks because something is deemed too complex. They were in deep distress and in deep need and were let down in that area.

The Mental Health Commission's interim report into CAMHS is a damning indictment of the crisis in our mental health services. The report illustrated how disjointed and under-resourced CAMHS is and how a failure of clinical oversight is putting children's safety at risk. The report highlights the following: the dysfunctional system of long waiting lists; poor clinical governance; staffing problems; children who have got lost in the system; a lack of capacity to provide appropriate therapeutic interventions; and a lack of emergency CAMHS out-of-hours services. I will come back to the last piece in a minute.

There was evidence of some teams not monitoring antipsychotic medication. Mental Health Reform was deeply alarmed that some CAMHS teams are neglecting to monitor children who are using antipsychotic medication, which is very worrying. I am sure it is very frightening for parents to hear that their child might not be monitored on something like this. They were taking medication without appropriate blood tests. Physical monitoring is essential when on this medication. These practices could have some serious repercussions for children's and adolescents' physical and mental health both immediately and in the future.

In one particular CAMHS team there were 140 lost children. They were not literally lost but children who should have had follow-up appointments, including for review of prescriptions and monitoring of medication, but did not have an appointment. This happened as a result of paperwork or staff changeover. In addition, the Mental Health Commission stated it identified another team that had open cases of children where there was no documented review for up to 2 years. This risk had not been identified by this CAMHS service. Another team were attempting to identify an unknown number of cases that had been lost to follow-up following a change in staffing. Other teams had commenced a six-monthly review of their open cases following the Maskey Review.

Last week two presentations on digital patient records were made to the Joint Committee on Health. It was very clear at that meeting that we are not where we need to be in the introduction of electronic digital patient records. It is not acceptable for records to be lost because of staff turnover.

Obviously, we welcome the review of all open CAMHS cases, but further actions are required. The recruitment of a youth mental health assistant director was promised in the budget for 2023. As far as I am aware, recruitment has not yet begun on this.