Vulnerable children forced to wait for vital health services

MORE than 950 children were awaiting child and adolescent mental health services (CAMHS) in Cork at the end of March this year.

Some 240 children were on the waiting list for CAMHS services in North Cork at the end of March this year, with the region making up almost 25% of the entire Cork CAMHS waiting list of 951 children.

A further 175 children are awaiting CAMHS intervention in South Lee 3, along with 103 in South Lee 1; 53 in South Lee 2; 74 in North Lee East; 61 in Cork North Central; 74 in North Lee West; and 71 in South Lee/West Cork.

There were also 23 children on the waiting list for the Child and Adolescent Regional Eating Disorder Service in Cork at the end of March this year.

Addressing the CAMHS waiting lists in Cork, a spokesperson for Cork Kerry Community Healthcare said:

“We regret that young people cannot always access the CAMHS service as quickly as they, or we, would like.

“Management in Cork Kerry Mental Health Services are actively taking every measure to acquire the necessary resources, clinical and otherwise, to ensure a quality service for the children of Cork going forward.

“Long-standing recruitment challenges have faced several CAMHS teams in Cork Kerry Community Healthcare which, in turn, has affected waiting time targets,” the spokesperson added.

“Local, national and international efforts are continuing in order to ensure that all available avenues are explored to provide a staffing supply for mental health services, including CAMHS services.

“We are dedicated to enhancing accessibility to all services and CAMHS teams are taking a multifaceted approach to improving access.

“A dedicated ADHD team has been developed to address those waiting longest for access to CAMHS ADHD supports across Cork and Kerry,” the spokesperson stated further.

“The CAMHS ADHD team commenced seeing young people during the last week of October.

“At the end of March, the team have supported 99 service users, who have either been treated and discharged or are still being treated with another 25 young people scheduled to commence with the service.” The spokesperson also highlighted other pilot initiatives, including telemedicine clinics, which have been developed in the North Cork CAMHS team to increase capacity, which the spokesperson said “will help to address the waiting lists for that area”.

“A comprehensive wait list validation exercise has also been established by the North Cork team, which will be reflected in the waiting list figures going forward,” she added.

“It is planned that the efficacy of these initiatives in addressing waitlists will be reviewed and introduced to all CKCH CAMHS teams.

“We wish to reassure young people and their families that urgent cases are responded to on a priority basis, often within 24 to 48 hours.

“Referrals to CAMHS are prioritised according to their acuity and severity.

“In a crisis situation, we would urge the service user to engage with their GP, Southdoc, or present to the nearest emergency department, where necessary support will be available.” Just over a year ago, The Echo highlighted the story of a Cork father who had hit out at the lack of support for young people with mental health issues, after his daughter was left waiting months for services despite concerns over self-harming.

The father, who wished to remain anonymous, told The Echo in April 2023 that, despite these concerns, his daughter was yet to receive an appointment date for mental health services, after her case was passed from CAMHS to Jigsaw and back again.

“I’m not blaming the people on the ground in these services, that wouldn’t be correct - it’s the powers that be that need to act on this,” he said.

Recently, the same man revealed that, despite his calls for action, very little has changed.

He explained that, since The Echo last reported on the story, his daughter had once again been referred to CAMHS who once again rejected her referral and instead, recommended Jigsaw.

“Jigsaw then wrote to her GP who wrote a letter to CAMHS to support the view of Jigsaw that it is CAMHS and not Jigsaw that is better equipped to accommodate her,” he said.

“I spoke to CAMHS two weeks ago. They acknowledge that my daughter is now on their waiting list . . . as recommended by Jigsaw, supported by the GP.

“CAMHS states that there is a long waiting list and that timelines were impossible to give.” The Cork father also highlighted the continued impact the lack of mental health support is having on his daughter’s education.

“She failed many of her Junior Cert subjects, or didn’t go in to sit the exam.

“She has also missed many school days of the 23/24 school year.”

Cork CDNTs trying to cope with large caseload and staff vacancies

Some 756 children were on waiting lists for initial contact from a CDNT in Cork, including 161 with CDNT 9 and 146 with CDNT 5, according to the figures received earlier this year.

CDNTs were established across Ireland in recent years under the Progressing Disability Services plan, which aims to increase access to disability services across the country, with 11 teams set up in Cork.

As well as the initial contact waiting list, CDNTs in Cork are currently trying to cope with a caseload of 5,954 children and an average staff vacancy rate of 23% across all 11 CDNTs in the region.

A spokesperson for Cork Kerry Community Healthcare said it deeply regrets any delays for children and their families awaiting initial contact with a CDNT.

“We understand the difficulty and stress this can cause for children and their families, and we are working to address these delays.

“CDNT services in Cork are provided by Section 38 and Section 39 agencies,” the spokesperson added.

“While Section 38 agencies - Brothers of Charity Services and COPE Foundation - have been impacted by the HSE recruitment pause, Section 39 agencies - St Joseph’s Foundation, Enable Ireland and CoAction - continue to run local recruitment campaigns.

“CKCH are currently working with National Recruitment Services (NRS) as part of the HSE National Recruitment CDNT Targeted Recruitment Campaign to fill therapy vacancies in Cork and Kerry.” The HSE reportedly lifted its recruitment pause in recent weeks. It remains to be seen what impact that will have on the recruitment of CDNT staff in Cork.

Commenting on the latest CDNT waiting list figures, Sinn Féin TD for Cork North Central, Thomas Gould, said:

“Once again, we see shocking numbers of children with disabilities not able to access services.

“What is most concerning is that those waiting for a first appointment seem to be most concentrated in areas that are disadvantaged.

“These children are all extremely vulnerable. I am very frustrated that over 150 children in CDNT 9 are waiting for a first appointment.” CKCH said it should be noted that there has been a significant decrease in the numbers waiting for an initial contact from CDNT 9 in the 12 months from March 2023 to March 2024.

“Early intervention is key,” Mr Gould stated further.

“What children with additional needs in Cork get is so often no intervention. That is a disgrace.”

CKCH Response

Responding to The Echo’s series on Cork children and their fight for services, a spokesperson for CKCH said:

“We sincerely regret that anyone in need of our services has to wait longer than either we or they would wish.

“We wholeheartedly apologise to the young people and children who have been waiting for longer times in accessing much needed services and supports.

“Unfortunately and despite incredibly hard work done by our teams, there are waiting lists in some services which are too long.

“While there are reasons as to why these waiting lists have occurred, we are aware that what’s important for children and their parents/guardians is the work underway to address waiting lists.

“Intensive work is underway in every part of our services to reduce waiting lists,” the spokesperson added.

“We are using telemedicine, extended clinic hours, triage, working with S38 and S39 agencies, and a wide range of other initiatives and innovative practices harnessing the energies of all staff.

“Substantial efforts have been made across service areas to improve efficiency and patient outcomes and reduce waiting list times.

“For example, the transition to an integrated eye service in the new state-of-the-art Primary Care building in Ballincollig marks a significant step in the new model of eye care provision for 2024.

“From March 2023 to March 2024, the waiting list for eye care services for children has reduced from 3234 to 1174 - a 64% reduction.

“Through a waitlist initiative last October, we offered more than 3,300 appointments, with 2,252 attending, resulting in a substantial reduction in the waiting list for eye care services for children. We remain committed to seeing high priority patient referrals as early as possible.” CKCH also thanked the many staff involved for their hard work and commitment.

“There are areas where this work has already made a difference and we have had significant success with initiatives like waiting list blitzes,” the spokesperson said.

“However, we acknowledge that even more work is needed to address remaining waiting lists, and we continue to make improvements so that we can provide the care needed as quickly as we can.

“We would also like to reassure the public that across all our services, urgent cases are prioritised, which means that those in the most urgent need are seen more quickly than others.

“As a general point, we’d like to point out that waiting lists are due in part to the ongoing increase in the number of people needing to access services,” they added.

“For example, CAMHS are seeing a 31% increase in referrals. Despite this, we are responding to more than 90% of urgent referrals within three days.”