A senior HSE representative has said that despite the recommendation to have a minimum of four full-time child psychiatrists working in Co Kerry, there are currently none.
Reviews into Child and Adolescent Mental Health Services (CAMHS) in north and south Kerry have identified risks of potential for harm in how young people were treated.
The 2022 Maskey report into south Kerry CAMHS found the care of hundreds of young people did not meet standards it should have, including unreliable diagnoses, inappropriate prescriptions and poor monitoring of treatment.
That prompted a review into services in north Kerry, published yesterday, which found a risk of potential for harm in more than half of files it reviewed – citing similar concerns.
It found that resources for the CAMHS team were significantly below what is recommended in national mental health policy.
Dr Colette Halpin’s report said that Co Kerry should have a minimum of four full-resourced dedicated CAMHS teams, including four consultant child and adolescent psychiatrists and full multi-disciplinary teams.
However, the HSE’s clinical lead for youth mental health said this morning that there is not currently any consultant working full-time on CAMHS in Kerry.
Speaking on RTÉ’s Morning Ireland programme, Dr Amanda Burke said: “They don’t have them at the moment. Recruitment and retention continues to be a challenge and we are reaching out … nationally and internationally, to get this.
“But as I said, we’re not an outlier. This is happening internationally. Recruitment of consultant child and adolescent psychiatrists is an international problem.”
Asked how many consultants were working in the county, she said: “They have a number of consultants inputting.
“There are more than four consultants inputting but they are not full-time consultants and there are a number of arrangements in place.”
Pressed on how many consultants were working full-time, she said: “There is no full-time consultant at this moment in time, as I understand.”
Dr Burke did not provide information on how many whole-time equivalents were working in the county and the HSE has been contacted for clarification.
She said there was “widespread acknowledgement” of workforce challenges in CAMHS both nationally and internationally, adding that it is a particular issue in rural areas.
“We have a plan to remediate that but it’s something that takes consistent year-on-year funding and a clear recruitment strategy,” she added.
HSE apologises for standard of care
Dr Amanda Burke said “the HSE is really sorry” for the standard of care described in the report.
She said it “is not the standard of care that children, young people or families should ever experience and they deserved better.
“But what I do want to say is that the HSE is committed and has been committed since the publication of the Maskey report – Minister Butler established a child and youth mental health office, and I’m the national clinical lead for that – to drive reform at a national level.
“And we’ve undertaken a significant programme of change, including strengthening clinical governance and oversight, introducing clearer standards and accountability structures,” added Dr Burke.
CAMHS report demonstrates challenges within mental health system
The policy and research manager for Mental Health Reform, Dr Louise Rooney, said yesterday’s CAMHS report was “really shocking” and “demonstrates the challenges” within the mental health system at the moment.
Also speaking on Morning Ireland, Dr Rooney said it is “quite clear” that a number of things need to happen to instill people’s confidence back into the system.
“People are going to be taking their children today to CAMHS appointments. They deserve to feel confident in the services that they’re accessing and that sense of trust is something that is going to have to be built back up,” she said.
Dr Rooney said they are calling for the reinstatement of a lead for mental health in the HSE to “strengthen oversight and increase accountability”.
She said a statutory right to independent advocacy is also needed.
“Parents talk about that they were unaware of the side effects and potential consequences of some of the psychotropics that their children were put on. The children also said that they felt that they weren’t listened to,” Dr Rooney said, adding that they were also calling for an independent complaints mechanism.
“The HSE has a complaints service called ‘Your Service, Your Say’, but it’s not independent. You’re essentially complaining about the HSE to the HSE,” she explained.
“In order to really have independent complaints investigated in a robust and fair manner, that is something that we’re calling for,” added Dr Rooney.