Thomas Pringle (Donegal, Independent)
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6. To ask the Minister for Health what steps are being taken to improve the recruitment for all grades involved in CAMHS in order that fully resourced teams can be in place across the country; and if he will make a statement on the matter. [9414/24]

Mary Butler (Waterford, Fianna Fail)
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Investment in child and youth mental health services has been a priority for me and this Government, and is exemplified through the year on year increased investment into CAMHS over the lifetime of this Government. As additional CAMHS teams have been established, staffing has increased in parallel.

More specifically, the HSE has increased staffing in community CAMHS from 388.76 WTEs in 2011 to 659 in December 2021 to approximately 820 posts by the end of 2023. This is an increase of more than 50% over the last 12 years. In addition, I announced a further 68 posts for youth mental health as part of Budget 2024, and the further announcement of €10m earlier this year will bring the total number of people employed by CAMHs above 900.

The HSE continues efforts to recruit for vacancies as quickly as possible, ensuring that those who are recruited into CAMH services have the skills needed to meet the care needs of young people experiencing mental health difficulties. In addition, the HSE is fully utilising opportunities offered by telehealth technologies to mitigate recruitment challenges and modernise delivery of care. This rounded approach is in place to ensure that children and young people can access the care that they need, when they need it. This approach is further supported by the utilisation of CAMHS Hubs. The new multi-disciplinary Model of Care for CAMHS Hubs, which I launched on 7 September last, is currently operational across 5 pilot sites in CHOs 2, 3, 4, 6 and 8. Support from these Hubs is designed to be provided to young people over a short period of time, as they provide targeted and intensive interventions with flexibility to respond to different young people’s or parent/carer needs.

In response to the Deputy's question, the HSE has also committed to offering all Nursing and Health and social care graduates permanent contracts of employment in the HSE. It is envisioned that this initiative will also help to increase CAMHS staffing levels across nursing and social care grades. In this context the HSE have advised my Department that they are now directly targeting fourth year health and social care students in both Irish and UK colleagues for opportunities across all services.

In addition, under the HSE's Resourcing Strategy, Expert Implementation Groups have worked to identify resourcing challenges within grade categories and professions to recommend resourcing actions to address them. To date this strategy has resulted in the development of additional Trainee psychology places, increased training places across Health and Social Care Professions, and provided additional funded Medicine placements and increased the number of training places for undergraduate mental health nursing.

Key statistics:

·There are 76 Community CAMHS teams and 4 in-patient units nationally.

·The HSE has significantly increased staffing in community CAMHS to approximately 820 posts at present.

·The 68 new posts allocated under Budget 2024 increases this figure to 888.

·This figure will be further augmented by new posts under the €10 million Minister Butler recently announced.

Key messages: Use speaking note format

·The development of CAMHS is directed by our national mental health policy Sharing the Vision (StV) which is the successor policy to A Vision for Change.

·A Vision for Change was prescriptive on the composition of multi-disciplinary teams and staffing levels required to serve a given population.

·In contrast, StV recognises that in line with current best practice and to enable future flexibility in terms of service delivery, additional competencies are recommended for multi-disciplinary teams, to complement core skills.

·In addition to core skills like psychiatry, social work, clinical psychology and occupational therapy, additional competencies like dietetics, peer support, outreach and job coaching, for example, may be appropriate.

·Rather than being specific on staffing numbers and team composition, a flexible approach can be more responsive to local needs which helps achieve recovery-oriented outcomes.

·As additional CAMHS teams have been established staffing has increased in parallel.

·The HSE increased staffing in community CAMHS from 388.76 WTEs in 2011 to 659 in December 2021 to around 820 posts at present.

·This figure will increase significantly this year with the additional posts Minister Butler secured for CAMHS.

·The HSE continues efforts to recruit for vacancies as quickly as possible, with the skills to meet the needs of young people.

·The HSE is fully utilising opportunities offered by telehealth technologies to mitigate recruitment challenges and modernise delivery of care.

·This includes a new multi-disciplinary Model of Care for CAMHS Hubs launched by Minster Butler on 7 September last, with pilots across five sites.

·The HSE is operating in a fiercely competitive global race for talent across all professions in which the mobility of healthcare workers across the globe has become an ever-increasing challenge.

·The HSE fully understands the requirements to build our workforce now and into the future to meet the increasing needs of services including CAMHS.

·To this end, the HSE has established a national resourcing strategy for the HSE ‘Resourcing our future’.

·This is an action orientated programme of work which includes initiatives such as the development of a career hub.

·The hub, provides potential candidates with automatic notifications as roles are advertised and allows for targeted engagement/marketing and profiling of services, the CAMHS services is expected to be subject of one of these profiles in 2024.

·The HSE has also committed to offering all Nursing and Health and social care graduates permanent contracts of employment in the HSE.

·This initiative should help to increase CAMHS staffing levels.

·The HSE is now directly targeting 4th year Health and social care students in both Irish and UK colleagues for opportunities across all services.

·Under the Resourcing Strategy, Expert Implementation Groups have worked to identify resourcing challenges within their grade category and professions to recommend resourcing actions to address them.

·To date the programme has added additional Trainee psychology places which commenced in September 2023 over a three year period, increased the trainee cohort across Health Social Care Professions, provided additional funded Medicine placements and increased the number of training places for undergraduate mental health nursing.

·The Recruitment Reform & Resourcing Programme, established in June 2022 is also working to identify resourcing deficiencies within the HSE.

·While the existing Recruitment Operating Model is working to reduce the time it takes to recruit and to bring the selection decision and control closer to the services.

/ie/oireachtas/debates/questions/supportingDocumentation/2024-02-29_pq6-29-03-24_en.pdf">CAMHS

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for his question. Ensuring that children have access to inpatient mental health beds is a priority for me and this Government.

There are four inpatient CAMHS units in Ireland, namely Eist Linn, Linn Dara, Merlin Park and St Vincent’s. These Units, also known as Approved Centres, are registered, regulated and inspected by the Mental Health Commission. While CAMHS in-patient bed capacity is 72 beds nationally, currently, due to a range of issues including staffing and necessary renovations, there are 51 beds in operation. The HSE is making every effort to address service challenges and bring the number of beds in operation back to 72.

It is important to note that access to these inpatient beds is being carefully and actively managed by the HSE. As of 13 February 2024, the waiting list nationally to access units was 0. At present, approximately 35 (68%) of available beds are currently occupied, therefore even with the reduced operational beds, there remains capacity to admit to CAMHS inpatient units. All four CAMHS units are working collaboratively to maximise national CAMHS bed capacity and to minimise the impact of this temporary reduction.

The CAMHS waiting list for inpatient beds fluctuates each week and is monitored and discussed at a weekly CAMHS inpatient bed meeting between the four CAMHS inpatient units and HSE National Mental Health Operations. There is also a weekly call with both the Children's Health Ireland (CHI) and Southern Hospitals Groups to identify any delayed discharges which is working well.

The Department of Health is provided with an update from HSE National Mental Health Operations on CAMHS Bed Status on a weekly basis, and this is actively monitored and reviewed by officials in my Department.

The HSE will continue to utilise all available options to care for urgent cases, including the use of private providers if needed.