A MOTHER WHO says her teenage son has been “let down constantly” by Child and Adolescent Mental Health Services (CAMHS) based in the Midlands has welcomed the announcement of a nationwide audit of the services.
The woman, whose son has been attending the service since 2013 claims he has been prescribed the wrong medication “many times” and that he has been admitted to A&E four times since November after saying he was going to take his own life.
Her husband quit his job last year to be at home with their son because his family do not deem it safe for him to be there alone.
It follows revelations contained in a report last week that 46 children suffered “significant harm” while attending the HSE-run South Kerry CAMHS.
The report also found that 227 children who were treated by a non-consultant doctor employed at the service were exposed to the risk of significant harm due to the doctor’s diagnosis and treatment of them.
The HSE apologised following the publication of the report, which the Taoiseach described as a “damning indictment” of the service.
The board of the Mental Health Commission (MHC) said today that it has written to Minister for Mental Health Mary Butler about the HSE report, saying it represented “a catastrophic failure of oversight, supervision and accountability”.
The board’s letter said that although the onus for change and improvement lies with those managing and working in services, independent oversight is required in future to ensure that the report’s recommendations are fully and effectively implemented.
Chief Executive of the Mental Health Commission, John Farrelly said the harm outlined in the report “must be the catalyst for change”.
“The time for reform of Ireland’s mental health services is now and it should begin with the reinstatement of a National Director for Mental Health in the HSE,” he added.
“This is something which the MHC has advocated for since the removal of this critical position in 2017 and which was referenced by the Minister in the Dáil last week.”
HSE chief Paul Reid said last week he wanted to reassure families that all 73 CAMHS teams around the country will be properly assessed.
Speaking on RTÉ’s Morning Ireland on Friday, he said: “What we are going to assess now is how the multidisciplinary teams work; what’s the process for records administration? What’s the process for engaging with families and other agencies and schools?
“We will also be looking at the clinical prescribing practices in each of the 73 teams, and right now, our clinical leads on mental health and patient safety are defining the full scope of that audit to support that assessment of prescribing practices.”
Audit welcomed
Speaking to The Journal, a woman whose teenage son used another CAMHS service in the Midlands welcomed the HSE’s audit last week, but said she has concerns about what its outcome might be.
“Is anyone going to be held accountable or will they just hire more management instead of putting money into services?” she asked.
Her teenage son has been attending a CAMHS service in the Midlands since 2013, but she indicated that there are not enough resources to support him.
The boy has oppositional defiant disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD) and autism, which means he also attends School Aged Team Disability Services.
“He’s struggling. He’s crying out for help,” she said.
She said she has turned to private care in order to try and help her son. Both she and her husband have spent around €2,500 on psychiatrists for their children, and around €100 a week for a psychiatrist to call to their home.
“He really – and I’ve been saying it for months – needs in-service treatment to try and help regulate him… but there’s nowhere to go.”
The woman believes a lack of resources is an ongoing problem at the service.
She said there are good staff that work there, but there are not enough people to cover the whole area, leading to appointments being cancelled.
“Every time you go in, there’s a different on-call doctor, and if you’ve a child with anxiety or autism, it takes them a long time to get used to someone. There’s no consistency. ”
One psychiatrist working there was “amazing”, she said, but after Christmas, she received a phone call from him saying that the HSE had not renewed his contract and was not replacing him.
It’s just being let down constantly. [They're] just happy enough to write prescriptions, but no interventions at all. And, you know, I’m constantly told it’s autism that’s doing this, that ‘this isn’t our department and so you may go back to disability [services]‘.
Asked about the outcome of the HSE audit, the woman said she hopes there will be more counsellors available to children “because it’s all very well to give medication, but alongside that, there should be counselling”.
“There are no services that say: ‘we’re going to help him here for four weeks and we’ll try and monitor his medication, work with him through counselling, CBT [cognitive behavioural therapy]‘, all that stuff in a controlled environment. But there isn’t anywhere.”
Ongoing problems
The woman said her family are “constantly tossed back and forth” between services for his different diagnoses. “That’s gone on for years,” she said.
Her son is on anti-psychotic medication and antidepressant medication. He is no longer prescribed ADHD medication.
“There’s so many different doctors that you’re speaking to,” she said.
She also said her son was admitted to A&E on Tuesday of last week after saying that he was going to take his own life, but a doctor working for the CAMHS sent him home and said they would receive an appointment for the following day.
However, she said the family were given an emergency appointment for Friday, three days after he was initially admitted. The doctor also told her to lock away medication and anything her son could potentially use to harm himself.
She said her son told staff that if he were sent home, he would try to harm himself or someone else.
The woman said her family have been to A&E four times since November and she said they have received little support because there are no beds available.
Her husband left his job last year in order to stay at home when their son was at home “because it wasn’t safe” for him to be there alone.
She alleges that nobody has checked her son’s blood levels since last summer. During that appointment, she was informed that his prolactin levels, the hormone responsible for the production of breast milk, was slightly raised.
“He’s still on the same medication. They haven’t checked it since, which is six months ago,” she said.
“I’ll probably end up having to do it myself now again, which I always do, but there wouldn’t be anyone following up on any of his reports or blood labs. ECGs aren’t checked. I send them in for my own GP [to look at].
“All of our hospital experiences have been awful.”
In response to a request for comment from The Journal, a spokesperson for the HSE said: “The HSE cannot comment on individual cases. However should a patient or family who attend the service be concerned about a particular aspect of the care they receive, they should contact their Treating consultant or GP.”
They said that “like many other CAMHS services across the country”, this CAMHS team “experience challenges in respect of the recruitment of staff from time to time”.
They said the service “will participate in the audit of CAMHS services which was announced in recent days and the team will embrace opportunities to improve services”.
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