Child and adolescent mental health waiting lists in Cork up 23%

THERE has been a 23% increase in waiting lists for child and adolescent mental health services (CAMHS) in Cork in recent months, it has been revealed.
Clinical director for mental health services in Cork, Dr Sinead O’Brien, described the increase as “very concerning”, but added that CAMHS were making staff appointments and taking new measures to tackle waiting times in the region.

The latest figures show that there were 536 children waiting for mental health services in Cork at the end of September.

While the number of children waiting over a year for services has seen a reduction, Dr O’Brien said the increase in the overall waiting list was “very concerning” and comes during a “challenging time” for CAMHS across Cork and Ireland.

Dr O’Brien also highlighted a worrying increase in “morbidity” in cases.

“These are cases where young people are being referred with a more severe presentation, warranting secondary mental health care and specialised services,” she explained.

“That means more people who aren’t able to have their needs met in primary care.

“The increase in the overall waiting lists is concerning from our perspective.

CAMHS in Cork were implementing strategies to address the waiting lists, Dr O’Brien explained.

“Already we have secured consultants opting to work additional hours on top of their contracted hours to address the waiting lists,” she said.

“In terms of recruitment, we are following up on a number of potential consultants and we are hopeful we can address the vacancies, which would certainly hugely assist in terms of addressing the waiting lists.

“It’s very clear that there is a high level of need, and Covid-19 has exacerbated the symptoms and conditions, leading to increased demand for the service.

“As the clinical director, I am concerned to see the increase in the waiting list and we are looking at increasing our capacity to ensure we can meet the needs of the people who are referred,” she added.

“On a positive note, we have reduced the number of people who were waiting in excess of a year.

“I will be clear that no child or young person should be waiting more than a year.

“It’s welcome that there is a reduction in that area, but we would obviously like to be able to meet people’s needs in a much quicker timeframe.

“We certainly want to get to a stage where nobody is waiting that long.”

Consultant vacancies

There are two vacant CAMHS consultant posts in Cork — one in the city due to maternity leave, and the other in North Cork, which has seen the largest CAMHS waiting lists in recent years.

The North Cork area was designated another consultant position in January, making it a two consultant region. However, there has been just one consultant in the area since the other retired in July.

“We have the same level of service in North Cork now as we did last year, but it’s good news that we have an additional consultant post ready to be filled there,” explained Dr O’Brien.

“North Cork clearly warrants a second consultant and that larger team.

“North Cork is our biggest waiting list and it’s such a large area.”

Dr O’Brien added that she was keen to see the other vacancy, in North Lee West, filled sooner rather than later. In the meantime, she said, consultants from other areas were providing cover for the area.

“We want to fill that vacancy quickly because, even though there is cover from other consultants, it’s not the same as having one consultant there all the time, and this is evident in the growing waiting lists there,” Dr O’Brien said.

In January, there were 35 children on CAMHS waiting lists in North Lee West. That had since risen to 55 by the end of September.

“We had a low waiting list originally in North Lee West, but we have seen an increase in the area since the consultant post was vacated,” she explained.

“We have interviews set up with candidates, so we may be able to recruit quickly.

“However, it is very difficult, right across Ireland, to recruit consultants to CAMHS positions.

“There are just less of them out there and there is huge demand.”

Training CAMHS consultants

“One of the areas we’ve been working on in recent years is actually trying to train more of our own,” Dr O’Brien revealed.

“I think there is a workforce planning issue nationally and, in order to address the need nationally, we need to start training more specialists in CAMHS, which would result in more consultants becoming available to fill posts.

“Our priority is to fill those posts and we do have a good track record of recruitment in Cork.

“We have had good support from management, who recognise that sometimes we do need to recruit even if there is no post to fill at the time — it’s about preparing for retirements or other departures down the road.”

Dr O’Brien also revealed that there was a vacant CAMHS post in Kerry, which consultants from Cork have been helping to provide cover for in recent months.

“That undoubtedly has affected the number of appointments on offer in Cork, but we have to work together,” she said.

“There is no doubt about it that some of the increase in waiting lists was brought about by consultant vacancies. However, there is also no doubt that we have seen an increase in referrals as a result of Covid,” she added.

“At the start of the pandemic, we saw a marked reduction in referrals. However, as it has gone on, we have seen referrals increase right across the board in terms of both CAMHS and adult mental health services.”