Sign in. It’s quick, free and it’s up to you.
An account is an optional way to support the work we do. Find out more.
IRELAND’S PSYCHIATRISTS HAVE issued a “critically urgent” call for a major overhaul of the mental health service for children and young people.
CAMHS (Child and Adolescent Mental Health Services) provides assessment and treatment for young people up to the age of 18 who are experiencing mental health difficulties.
The College of Psychiatrists of Ireland has today called for “major reform of the management and governance of CAMHS” and has published a policy document outlining changes it wants to see.
It said the current governance of CAMHS has “serious deficits”, such as a “lack of clarity as to whom responsibility for action lay between local, regional and national governance structures”.
This “ineffective governance” is also contributing to a failure to manage risk, a failure to fund and recruit key staff, and a failure to provide standardised models of care across the country.
The College of Psychiatrists of Ireland is the professional and training body for psychiatrists in Ireland.
The move is an unusually strong criticism of CAMHS, but the College of Psychiatrists of Ireland said that “trust has been lost in CAMHS” and that new governance and management structures are required as a “priority” to ensure a “high-quality service”.
Dr Patricia Byrne, Chair of the Faculty of Child and Adolescent Psychiatry at the College of Psychiatrists of Ireland said that reform of CAMHS is “critically urgent”.
She noted that CAMHS is “under-resourced, under pressure, and under-performing – and if the recommendations are not implemented, this will continue”.
At a media briefing on the policy document, it was noted that it is “very difficult” to recruit staff, given a recruitment freeze last year and as a result of the pay and numbers strategy which replaced the freeze.
This strategy stated that the employment ceiling in the HSE would be capped at the December 2023 numbers.
Byrne noted that some teams are “seriously understaffed”, and that there had been a failure to fund and recruit key staff.
She also warned that if the recommendations are not acted upon, more young people will be on waiting lists, and “more staff will end up burned out, working in a system not fit for purpose”.
She noted that the damning Mental Health Commission report on CAMHS published in 2023 “identified national deficits in team staffing and lack of minimal required resources to facilitate service delivery”.
The report found that the State cannot provide assurances that children have access to a safe, effective and evidence-based mental health service.
It also found that many children and young people end up “lost” in the system; in one catchment area alone, there were 140 “lost” cases within the local CAMHS team.
Byrne said the report highlighted a “crisis” in CAMHS and that “ineffective governance in some areas is contributing to an inefficient and unsafe” service.
The College of Psychiatrists said this 2023 report details failures in governance at a national and regional level, including insufficient funding and resourcing of CAMHS, serious deficits in digital infrastructure, and chronic and ongoing understaffing.
“Sadly, this has resulted in negative impacts in service experiences for young people and families who require our services, and for the front-line staff trying to deliver care,” said Byrne.
“As such, a major reform of the service is of critical and unparalleled importance to the wellbeing of those patients and their loved ones.”
Elsewhere, the psychiatrists also warn about a “reliance on medication”, without the required therapy to go alongside it.
While Byrne said medication will always be used in line with good practice and governance, she cautioned that some young people may only be able to access medication because of the long wait lists for therapeutic support.
Among the key recommendations within the policy document published today is for all staff working in CAMHS to receive specialist CAMHS-specific training to ensure optimal standards of care.
It also calls for specialist child and adolescent psychiatrists to lead each CAMHS team, as well as the creation of a new senior management role, the Clinical Service Manager (CSM), at a team and regional level.
This would be a senior role supporting and working alongside the consultant, with the ultimate aim of providing a “gold-standard service”.
This is a role that the College of Psychiatrists said it is “really strongly advocating for” and it would be a part-time senior management role to help deliver a “comprehensive, integrated child and adolescent mental health service across CAMHS”.
The CSM would be responsible for efficient management, coordination and administration of each specialist team.
The College of Psychiatrists said that investing in management will improve services and result in better outcomes.
The report recommends that all members of the CAMHS multidisciplinary team should have “clearly defined roles and be clinically accountable to the specialist consultant psychiatrist as the clinical lead”.
There is also a call for an “appropriate digital infrastructure”, noting that many psychiatrists are still using pen and paper.
The College of Psychiatrists of Ireland said this lack of proper digital infrastructure is “associated with governance failings, including patients being ‘lost to follow up’, loss of clinical records, and reductions in the quality of patient records”.
It added that this issue also “significantly increases workload on clinical staff performing administrative duties, further reducing the already under-resourced clinical capacity”.
Dr Lorcan Martin, the president of the College of Psychiatrists, said the recommendations outline “radical new governance and management structures”.
He added that they would “lay solid foundations for the development of a world-class mental health service of which we can all be proud” and he called on the government to “act urgently to implement the recommendations contained in the proposal”.
Ain’t the media great to give these protests wall to wall coverage…
@Derek Durkin: Goddamn media reporting the news, despicable if you ask me.
@Diarmuid Hunt: yeah because that’s how the media works yeah….not too bright are we
@Derek Durkin: I didn’t say they weren’t selective. Nice ad hominem though.
If you choose to chain or glue yourself to objects, you should be left to protest unaided for 24 hours or at least until you toilet yourself.
@Mick Byrne: Do you really give a **** about what you claim to believe in?
@Mick Byrne: You’re only giving them ideas! Dirty protests are not unheard of in this country…
@Mick Byrne: And to ask what toilets do they use or do they tow mobile toilets with them.
Bunch of hypocrites should be all arrested
@Jim O Brien – TechBuzz Ireland: Arrested for protesting? Are you sure about that?
@Shakka1244: they’re breaching the peace so they can be arrested, there is nothing peaceful about pushing through a barricade and chaining yourself to a gate also it’s worth noting that assembly near or at the dail can be controlled or shut down under article 40 of the Constitution. At this stage their numbers are dwindling and they’re getting desperate for media attention, this little stunt just proves it. Sure their little March through Penneys on Mary street completely backfired, there was killings on Twitter because they came across as elitist and snobby.
@Peej: I think you’ll find that many could see that they weren’t elitist or snobby, more highlighting the abhorrent working conditions of the sweatshops used to fund the functioning capitalists who sell such items by mass production, shops like Penney’s capitalize on the detachment of works who are often as young as 12 brought from urban areas to big cities to be exploited for the good of the western consumer, whilst the big chains relish in the reward,.
Get in those lads the council employed . Seemed to work a dream
Arrest them all already. Waste of tax payers money. Right to free protest has long since passed
@Gareth Murran: Are you saying that anyone that protests should be immediately arrested? Since when did we become North Korea?
@Shakka1244: if XR on their manifesto are encouraging civil disobedience and not protests, by its very nature, their intention is to be arrested!! There is a difference between cd and protest.
@Jennifer Hampson: Yep, civil disobedience pretty much guarantees time in custody. It depends on whether enough people think the cause is worth it & if enough do, change will soon follow. Time will tell if they keep it up but if the climate keeps getting worse, it’ll only go one way.
I thought it already was an open house if you were in the know!!!!!!
Ruined a great event for the general public. And now the hippies will wonder why they ain’t getting support? Plant a hemp tree somewhere and smoke it when it finally is big enough.
TD are the one making the issue of carbon with this tax to handle the public deficit . Twenty per cent of that national debt made up of a deal made by a minister with IMF ad EU never laid before the Dail .
When did a minister get authority to treat his deal as law of land without consnet of Dail and Oireachtas ie legislation making deal part of law
and
How can TD vote on estiamte if the Dail has no control over what in kitty to spend whihc it does not until that deal laid beofe it by min?
Commission can serve notice on ireland to reduce that deficit (64.8 per cent in excess of the 60 per cent threshold under the Fiscal Compact Treaty per ntma report at end of 18 with loan of 44 billion from eu and uk ) as an DEBTOR to EU ??
TD complaining about not enuf spend are only putting us into deeper debt and only DAIL can change situation by TD having minister LAY that EU/IMF deal before the dail that will reduce deficit until DAIL approves terms by voting thru legislation making it part of law of state. Term that public spending complies with deficit rule but also public funds will cap bank cos share value fall cos of ECB policit we have no control over.
Minister have to acknowledge a debt cos min signed loan agreement .
But TD seem to want to have cake and eat it want to complain about govt , overspending or underspending but not taking control of the fund but seem to have no problem voting thru these estimate . Think it will carry on until voter tell local TD .. hey why isnt that deal before Dail? We elect U to be responsible for whats in kitty to spend not minister ?
have your say