Wednesday, 18 December 2019
Department of Health
Child and Adolescent Mental Health Services
The National Youth Mental Health Task Force was established in response to an undertaking in the Programme for Partnership Government. The Task Force report was published in December 2017 and it was suggested that the time-frame for full implementation should be three years. The report made recommendations in 10 different themed areas. It also identified lead agencies associated with each recommendation that would be tasked with developing and/or implementing these as appropriate.
Since publication of the Task Force report, a number of the recommendations have been incorporated into the service plans of lead agencies for 2018/2019. The implementation of these recommendations has been on-going. A small number of recommendations require further consideration. It is anticipated that the majority of recommendations will be implemented by 2021. Related to this, approval is currently being sought from DPER to establish a Pathfinder inter-departmental unit on youth mental health.
In addition, the successor document to a Vision for Change also supports full implementation of outstanding Task Force recommendations before December 2020. A full list of updates on initiatives is attached for your information.
|Consultation and Advocacy |
1.1 - Pathfinder should take a lead in formalising mechanisms to ensure that the
voices of young people are fully considered in the development and
implementation of legislation, policy and services for youth. The Pathfinder
team should develop mandatory protocols which will work to safeguard young
people against potential changes in policy that could negatively impact on youth
1.2 - Policies involving young people should be published in simple, straightforward
language that young people can understand
1.3 - A process of youth consultation should be carried out when designing mental
health and other support services and facilities for young people
1.4 - An independent National Youth Mental Health Advocacy and Information
Service should be established. Consultation should be informed by children and
young people and should include the HSE, which is developing a tender for a
Child and Adolescent Mental Health Services (CAMHS) youth advocacy pilot.
|Work has been advanced to establish a Youth Mental Health Pathfinder Team. A submission was created on behalf of the Secretary General of the Department of Health for submission to DPER. Since then there has been considerable communication and work performed in addressing outstanding governance, staffing and funding issues. Activities are not yet complete in fully developing and rolling out a pathfinder unit, but work is on-going. |
Policies involving young people are issued to the young people’s forum in DCYA for review prior to publication.
This is to be a part of the Pathfinder project once agreed.
A pilot adult inpatient advocacy service is being rolled out in St Patrick’s Hospital and the HSE will use the learning’s from this pilot to determine how best to establish a young advocacy service. Work has been completed to determine the merits of establishing the advocacy service as (i)a separate structure independent of the HSE, (ii) a structure within the Child Ombudsman or indeed (iii) a new NGO agency. A draft business plan has been drafted and data from the HSE pilot will provide a template for how best to proceed in an Irish context.
|Awareness and Training |
2.1 - A series of sustained and evidence based awareness campaigns should be
developed, specifically targeted at children and young people, to improve mental
health, emotional literacy, build resilience, and aid the development of coping
2.2 - Sustained, quality-assured and evidenced-based training programmes should be
funded to provide support to individuals in the public, voluntary and community
sectors who have contact with young people so that those trained might be in a
better position to promote positive mental health
|The HSE have been examining International awareness initiatives that might be applicable in this jurisdiction. |
Little Things Mental Health Campaign for 2nd level students:HSE Mental Health has been running the Little Things Campaign since 2014 to promote protection and improvement of mental health for the whole population. The campaign focuses on 9 protective factors that can help build resilience and improve mental health and wellbeing.
Work commenced on adapting the Little Things Campaign to tailor the messaging and make it more relevant to young people, who are also listed within Connecting for Life as a priority group. Using research conducted by online youth mental health service, ReachOut.com, which highlighted key areas of stress for young people the HSE identified 6 issues to include in the new campaign; Exams, Sleep, Digital devices and Bottling up your feelings, Relationships and Image.
Imagery and messaging has been developed for 4 of the key areas and will be made available as poser packs to schools, youth and sports clubs around the country. The messaging has been developed to inform young people about the things they can do to reduce stress and anxiety.
The campaign will be promoted on Radio, Social Media and through Digital ads targeting young people through relevant channels. We will be signposting to yourmenalhealth.ie for more information on the topics and will also promote the Childline text and phone option for any young person that might need immediate support. Content on all 6 issues, developed in partnership with SpunOut will also be hosted on ymh.ie.
HSE/USI ReCharge Mental Health Campaign for 3rd Level Students:HSE Mental Health is also funding a new Mental Health awareness campaign with USI to target third level education students. This campaign is due to be launched in University College Cork. The HSE funding has been used to create a new campaign logo and tagline, three new posters to address the effects that Alcohol, Sleep and Exams can have on mental health and ways to help manage any stress related to those issues. A new leaflet with more information on protective factors and ways to seek help will also be produced as well as content on both USI.ie and yourmentalhealth.ie. USI is the national representative body for 374,000 students in 3rd level education and also receive funding from the HSE to provide training courses in SafeTALK, ASIST
Mental Health First Aid
Mental Health First Aid training for young people
HSE Mental Health funds Mental Health First Aid to deliver courses to various target groups. Participants learn the signs and symptoms of mental health problems and what sort of help has been shown by research to be effective. The training has been shown to improve attitudes towards people with mental health difficulties, reduce stigma, improve knowledge, and improve people’s confidence in providing help and likelihood to advise people to seek professional help. Over 2000 individuals and professionals have been trained in 2019.
The HSEs Specialist Perinatal Mental Health Services Model of Care was launched on 30.11.2017. Its implementation is now being directed and overseen by the Clinical Lead and Programme Manager. Specialist Perinatal Mental Health Teams are being recruited for the maternity hospital/service hub in each of the six Hospital Groups. Two of the teams are now operational. As part of this implementation a mental health midwife is also being recruited for each of the maternity hospitals/units with two for the four larger services, those with over 8,000 deliveries per year. Apart from the perinatal psychiatrists heading up each specialist hub team who are directly trained in the speciality, all other staff will require training in perinatal mental health. The National Implementation and Oversight Group is in the process of drafting a training document and in the meantime all newly recruited staff are being provided with the appropriate induction and training.
|National Telephone Line |
3.1 - The Taskforce recommends increased investment in age-appropriate, scalable digital youth mental health supports in conjunction with existing providers to ensure all young people ages 0-25 have access to an active listening service and dynamic signposting tool.
|HSE Mental Health has established a single and stand-alone National Mental Health Service Telephone Contact Facility to effectively manage mental health service related queries emerging from the community. This service was launched in November 2019 in the National Ambulance Service and operates on a 24/7 basis to provide: |
(i) information about, and direction of callers to, the most appropriate national and local pathway(s) to care specific to the query raised, and (ii) where possible the direct transfer of callers to the most appropriate existing helpline partners and/or services as required.
|E-Mental Health Strategy |
4.1 - Families, guardians and carers should be supported in parenting children and young people through the provision of universal, quality-assured and evidence-based parenting information and support programmes.
4.2 - Evidence-based information, interventions and signposting tools about mental
health should be included into routine perinatal care services.
|The HSE launched ‘yourmentalhealth.ie’ . This website provides advice, information and support services for mental health and wellbeing. |
The HSE is launching an active listening service (Live Chat, Instant Messaging & SMS) in early 2020. Volunteers have been trained and clinical governance agreed. Vodafone will deliver service in January 2020.
HSE is working in close collaboration with an existing service partner, SpunOut.ie/Community Creations, to act as the host/incubator organisation for the service on a pilot basis with contractual and service level arrangement negotiations now complete.
Following a decision of the Project Steering Committee in January 2019, two telepsychiatry pilots are now being undertaken. These pilots encompass the following:
(1) Remote consults to address CAMHS waiting lists.
(2) Remote consults on national adolescent addiction and substance abuse service.
It is also envisaged that a third pilot may be undertaken to assist reducing remote access and creating additional capacity and remote team consultations.
|Schools And Youth Mental Health |
5.1 - The Department of Education and Skills should support teaching professionals
in schools and centres for education with the knowledge and skills to understand
their role in supporting young people with mental health issues and how to access
information about services and supports available to them.
5.2 - Principals and teachers should be supported to implement the wellbeing junior cycle curriculum.
|The Department of Education have recently made changes to the Junior Cycle Wellbeing Curriculum. Additional hours have been allocated to mental health and awareness. |
There are now 400 hours of Wellbeing education in the Junior Cycle curriculum. Indicators of wellbeing are embedded into all subjects. A key strength of the these reforms is that young people will write up a report, report back on their learning, and earn a certificate. Parents can look at schools which perform well in wellbeing league tables.
|Third level supports |
6.1 - The current provision of counselling and mental health supports in higher level institutions should be maintained and enhanced
6.2 - The Higher Education Authority and the Department of Education and Skills should develop appropriate indicators to assess student experience in higher education in the system performance framework for higher education
6.3 - Prioritise the implementation of recommendations contained in “Mental Health Matters”
|The Department continues to support PCHEI with provision of additional counselling supports in third level institutions, though final authority rests with the Department of Education and Skill, as third level institutions are educational establishments. An evaluation piece is needed and HEI will provide input as to what additional counselling might be required before a final submission will be made. |
Department of Education agreed a package of €57 million in additional current funding to be invested in higher education initiatives in 2019 alongside €41 million additional funding for pay deals and pensions in the sector. This will fund provision for 3,500 additional places, initiatives to support innovation and performance awards, teaching and learning capacity, 1,000 additional places on Springboard+, research funds for Institutes of Technology/TUs, part-time and flexible learning. There will be also be a strengthening of counselling services in higher education. Total funding in higher education will be €337m higher in 2019 than in 2016 (current funding increase of €260m since 2016 and capital funding increase of €79m since 2016). Capital investment of €150 million will also be allocated to the higher education, further education and training and research sectors in 2019.
HSE Mental Health is also funding a new Mental Health awareness campaign with USI to target third level education students. This campaign was launched on the 12 November 2018 in University College Cork. The HSE funding has been used to create a new campaign logo and tagline, three new posters to address the effects that Alcohol, Sleep and Exams can have on mental health and ways to help manage any stress related to those issues. A new leaflet with more information on protective factors and ways to seek help will also be produced as well as content on both USI.ie and yourmentalhealth.ie. USI is the national representative body for 374,000 students in 3rd level education and also receive funding from the HSE to provide training courses in SafeTALK, ASIST
|Community Supports |
7.1 - The Task Force recommends that local government work with relevant agencies, youth groups and community groups to provide safe, ‘youth friendly’ spaces, sporting and cultural facilities that are conducive to promoting good mental health. These should include the provision of pleasant spaces and facilities for young people to access qualified health and mental health care in the community.
Evidence-based, quality-assured training in youth mental health should available to all individuals working with young people in the community
|The provision of Youth Friendly Spaces in community settings is a high priority for local government. Working with youth groups and community groups, service providers have been asked to try to include youth friendly spaces so that mental health can be supported. The thrust of Government policy has been towards enhancing mental health support in the community since ‘A Vision For Change’ was adopted in 2006. This policy will be continued when the refreshed policy is published later this year.|
|Accessibility and Alignment |
8.1 - Pathfinder should carry out a detailed assessment of the services and supports currently available in relation to youth mental health, in order to identify gaps in service provision and to scope what improvements could be achieved through greater coordination
8.2 - The HSE should improve provision of mental health supports to young people at the primary care level to reduce the pressure on the tertiary referral services and improve waiting times
8.3 - The HSE should establish a National Lead for Youth Mental Health and a Lead for Youth Mental Health in each Community Health Organisation (CHO) to co-ordinate the provision of services and address gaps in service provision, including out of hours services. The CHO Leads will liaise with relevant agencies to develop appropriate communication protocols, standardised assessment processes and coordination of service provision. This joint working will bring together expert stakeholders to identify and address potential blocks to service provision and seek to reduce current wait times nationally with the introduction of other more appropriate interventions in primary care.
|Assessments of current services are being discussed by TUSLA as part of their service provision in agreement with DCYA. They have initially suggested that overview of services would need to take place for all of their services, but that this would need to include mental health services and that therefore they may be in a position to complete this recommendation. I will have more detail once I meet with Tusla. |
Part of the recommendation refers to recruitment of HSE leads but the job specifications for full time staff are hard to define. At a recent meeting with HSE, Task Force representatives and NGO sector it was agreed to wait for the establishment of Pathfinder team to work on specific job specifications for the recommended posts.
|Consent Issues |
9.1 - Legislation should be published to give effect to the recommendations of the Expert Group on the Review of the Mental Health Act, 2001 with regard to children, including reforming the consent provisions, to allow young people under 18 direct access to mental health services
|There are on-going discussions and legislative work in the Department of Health regarding amending the legislation to allow children under 16 access mental health services without the need to have parental consent. Heads of Bill is currently being progressed.|
|Improving Knowledge |
10.1 - A funded strategic national research programme on youth mental health will be developed
10.2 - International sources of funding (for example from European Union or philanthropic organisations) should be leveraged to enhance this research strategy on youth mental health research
|There have been discussion with the HRB on how best to approach these recommendations. There will be a need for new additional funding and this will need to be tied in the with the creation of the Pathfinder Team who will have responsibility to create structures for administering grants and creating criteria for issuing research funding. |
PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies) programme of research, funded by the HSE, is investigating how best to deliver mental health services and interventions to families where a parent has a diagnosed mental illness. Recent years have seen growing recognition of the importance of parental mental health and the need for more integrated and effective service responses to parents with mental illness and their children (Wilson et al., 2010; HSE, 2015). This research aims to:
1. To identify mental health services in Ireland that currently deliver, or are interested in developing and delivering family-focused intervention(s) for families where a parent has a diagnosed mental health problem (and their children aged 0-18 years).
2. To subsequently investigate in more detail the implementation and effectiveness of selected interventions in order to inform a ‘think family’ care delivery agenda in Ireland (and internationally).