Frances Black (Independent) | Oireachtas source

The Minister of State, Deputy Butler, is very welcome to the Chamber. I thank her for coming to the Seanad to update us on the issues in this important debate. I agree with colleagues who have said that when CAMHS works, it works really well.I thank her also for her commitment. Nevertheless, the recent report of the Mental Health Commission regarding the state of CAMHS is truly alarming and very upsetting. I am grateful to Dr. Susan Finnerty and everyone else at the commission who worked on the report and brought this to our attention. I welcome Mr. Stephen Sheil from Mental Health Reform to the Gallery.

I spoke about this report in the Chamber last week, so I will try not to repeat myself. By now, we are familiar with the dire findings of the report and the hundreds of children lost in the system who went without follow-up, the children who were prescribed antipsychotic medication without proper medical monitoring, and the chaotic record-keeping and case management procedures that are exacerbating a crisis caused by persistent staffing shortages and chronic failures in governance. It paints an unbelievably grim picture. Imagine how you would feel if it were your child. It is devastating to think your child would not get the services he or she needs.

This crisis is severely damaging to the welfare and safety of some of Ireland's most vulnerable children. It puts a great strain on families and caregivers. As colleagues said, 741 children with mental health difficulties ended up in emergency departments for days because they were experiencing an acute crisis. Let us think about that. That they could not find help elsewhere is devastating. It is also very stressful and demoralising for the healthcare workers, who have to spend their professional lives working within a dysfunctional system, dealing with people who are at their wits' end with the stress and worry. These workers are drained, not only by the inherently difficult and emotionally intense nature of their work but also because they have to apologise to young people and their families on behalf of a broken system they lack the power to change. My concern is that the dysfunction of CAMHS has become almost a self-fulfilling prophecy. It is impossible to recruit and retain the necessary staffing levels when frustrated and burnt-out workers keep leaving due to the problems created by the understaffing.

CAMHS needs a significant overhaul, including ring-fenced funding, which other Senators raised, a minimum safe staffing level and enhanced accountability mechanisms. There needs to be an holistic approach to this issue, including more college places for CAMHS professionals and competitive salaries that reflect the difficulty of the work involved and the high cost of living in many parts of Ireland, particularly Dublin. The report notes the issues faced at the level of clinical leadership due to the shortage of consultant psychiatrists. The description of how scarce these professionals are throughout the CAMHS system is truly alarming and I hope it will serve as a wake-up call that the recruitment and retention of these consultants is vital.

This shortage could, however, provide an opportunity to explore further a shared responsibility model of multidisciplinary team leadership, something the Minister of State is passionate about. This would be in line with the holistic person-centred model of care envisioned in the Sharing the Vision strategy. Ireland has just been reviewed in Geneva regarding its compliance with its obligations under the UN Convention on the Rights of the Child and this report indicates we have a long way to go towards vindicating the rights of children with mental health issues to get the highest quality healthcare. It is unfortunate there has been a lack of progress in this area. There were 32 admissions of children to adult mental health units in 2021, up from 27 in 2020, but when the UN committee asked the Government when the number of children admitted to adult mental health units would be reduced to zero, the response, unfortunately, was that Ireland may never reach that goal. This shows a distinct lack of ambition to adhere to international human rights standards, which is deeply troubling.

I would love to hear more about the recruitment of a youth mental health assistant director being made a priority. That is very good news and I am happy to hear about it.

The Oireachtas Sub-Committee on Mental Health, which I chair, recently conducted pre-legislative scrutiny on heads of a Bill to amend the Mental Health Act, and this report underscores the vital need for the reform of that Act to proceed swiftly. It also highlights the need for provisions in the revised Mental Health Act to codify children's rights and ensure the provision of CAMHS will be shaped at every stage by the principles of care, dignity and security, which underpin children's rights under the convention. The subcommittee will have representatives from the HSE in within the next fortnight to discuss this report, and I look forward to hearing from them what actions they will take to rectify the issues raised in the report.

This crisis in CAMHS demonstrates how much work needs to be done in the mental health sphere, and I appreciate the Minister of State knows that. For too long, it has not had parity with physical health and that disparity can be seen throughout the system. There are the beginnings of a societal and political understanding of the need for change, but we have a long way to go, and in the spirit of parity between physical and mental health, the Sub-Committee on Mental Health should be given the resources necessary to be an independent committee. I have spoken to the Minister of State about this previously and acknowledge she is supportive of it. I thank her for that and hope we can build on that support.

A society's worth should be judged by its treatment of its most vulnerable members. If Ireland cannot provide a dignified standard of mental healthcare to our children who are suffering, it makes all the talk of economic growth, budget surpluses and the corporation tax take seem delusional and pointless. It needs to be made a priority because our children deserve so much more.