The €12m Distraction; Thoughts on the Child and Adolescent Mental Health Services in Ireland

The Faculty of Child and Adolescent Psychiatry is concerned that the recent focus and much talked about ‘€12million’ might distract us and all stakeholders from the main issue which is a chronic under-funding of Mental Health Services in Ireland.

The Faculty of Child and Adolescent Psychiatry in line with the College of Psychiatrists feel strongly that mental health funding should be increased to a minimum of 12% of the overall health budget, which would be an additional €800 million, as is the case in the UK. We feel that 25% of this should be allocated to children’s services, given their proportion of the population and the potential for preventative work which would benefit the whole community.

In general, we all have many individual areas where the supposedly un-allocated, unspent ring fenced money (12m) would be invaluable i.e. supplementing multidisciplinary teams with psychologists, social workers, occupational therapists and so on and in particular front line administrative staff. So it was with dismay we learnt that 12 of 35 was being siphoned off to another area of health care.

         How can the money be immediately spent in 2016?

The most recent intake of additional staff for community Child and Adolescent Mental Health (CAMHS) team was of basic grade staff with no provision for upskilling in mental health specialist competencies. This ‘12m’ would go a long way towards providing training, for example, in assessment and treatment of sensory processing disorders, which is a major concern for differential diagnosis of Attention Deficit/ Hyperkinetic Disorders. The recent reduction in senior grade specialists in CAMHS teams is also of concern and this money could be used to help us to retain our staff by allowing senior upgrades where merited, thus enhancing team cohesion and morale.

The lack of basic, appropriate working conditions i.e. safe, adequate premises with reasonable IT and administrative access is an issue for many teams and this money could assist in resolving this issue.

The need to develop / enhance child and adolescent mental health liaison in our paediatric services is self-evident. The money could be used to improve access to emergency services that treat patients in the right place, at the right time by the right person in line with patient preferences. This is also important when considering the needs of young people and their families coping with chronic and terminal conditions. It has long been recognised that children with medical illnesses experience significant psychological and psychiatric co-morbidity. Psychiatric illness has an impact on adherence to treatment, and thus outcomes, in chronic illnesses and liaison teams are important assets in managing these issues and providing essential psychological insights for paediatric teams.

There are other obvious gaps in the network of services for at risk children including the lack of primary care and community psychology services as well as the severely restricted “after care” programmes for children leaving state care.

The list could go on.

Dr Helen Keeley, Chair, Faculty of Child and Adolescent Psychiatry