A report by the Mental Health Commission has highlighted significant deficits in the Child and Adolescent Mental Health System (CAMHS).
A report by the Mental Health Commission has highlighted significant deficits in the Child and Adolescent Mental Health System .
There was evidence of some teams not monitoring anti-psychotic medication in accordance with international standards. Consequently, some children were taking medication without appropriate blood tests and physical monitoring, which is essential when on this medication. Dr Finnerty inspected the provision of CAMHS in five out of nine Community Healthcare Organisations including CHO3 , CHO4 , CHO5 , CHO6 and CHO7 .The report notes that children and young people accessing child and mental health services with open cases had been"lost" when it came to follow-up care. In some cases children and young adults did not have an appointment for up to two years.
According to the HSE, in March 2022, a Healthcare Record Review was commissioned in respect of one of its CAMHS teams in the Mid West because it had a deficit of senior clinical capacity and this process led to an examination of all open cases within that team. In a statement, it said:"We will arrange further clinical follow-up for any child where that may be required from this review and will make direct contact with parents or guardians as necessary."
GPs told of"frustrating attempts" to get a child assessed and having to resort to sending a child to the Emergency Department in local hospitals to obtain a psychiatric assessment. This resulted in incidents being logged as there was no clinical cover to assess and treat emergency cases. One child waited four days in the Emergency Department until they could be assessed by a consultant psychiatrist.
There was limited understanding in a number of teams as to what constituted a risk, how it was assessed and how it was escalated.Some CAMHS teams were so frustrated, according to the commission, that they didn't"bother" to escalate risk anymore, because they felt there was no point, resulting in"a haphazard documenting of risks and minimialist generalised actions recorded on the CHO register".
"The result of this is the understandable frustration of parents and GPs, who then refer to CAMHS, although those children do not meet the moderate to serious mental illness criterium of CAMHS. Sometimes, they are then referred back to the primary care or disability services to wait once again on a long waiting list," according to the report.
The MHC says that having a service with no oversight or regulation leads to failure and that because it does not regulate the CAMHS community service, it has no power to compel change.
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