HSE chief apologises for Camhs failings

David Young, PA

The HSE's chef operation's officer has apologised for failures in mental health provision for young people as he conceded that some children are still waiting too long to access services.

Damien McCallion appeared before an Oireachtas sub-committee on Tuesday to respond to a critical report on the Child and Adolescent Mental Health Service (Camhs).

Last month’s interim report on Camhs by the Mental Health Commission outlined a series of concerns on service provision.

It found that several children and young people with open cases had effectively been “lost” in the system, meaning they did not have an appointment, in some cases for up to two years.

It painted a picture of a disjointed system that was difficult to access and lacking in monitoring and follow-up care in some cases.

The report also found that some teams were not monitoring children on antipsychotic medication, that most services had no IT system to manage appointments, and there was no ring-fenced funding for Camhs.

Acceptance rates of referrals to Camhs varied regionally between 38 per cent and 81 per cent, according to the commission’s report.

Addressing the Oireachtas sub-committee on mental health on Tuesday, Mr McCallion said: “I acknowledge that there are service deficits, both in terms of access, capacity and consistency in the quality of services we provide.

“On behalf of the HSE, I wish to apologise to any child or young person who has not received the standard of care they should expect.”

He said Camhs teams in Ireland receive nearly 22,000 referrals every year and deliver close to 225,000 appointments for children and young people who need support.

The senior HSE leader said the system was facing challenges around a growth in demand for services coupled with difficulties related to staff retention and recruitment.

“Between 2019 and 2022, referrals into Camhs have increased by 16 per cent, while the total number of appointments seen has increased by 10 per cent in that same period,” he said.

“As of end December 2022, there were 4,293 children and young people waiting to be seen, which represents an increase of 21 per cent compared to the year before.”

The MHC has published an Interim Report from an Independent Review of the Provision of CAMHS services, has found that children and young people accessing these services have been "lost" to follow-up care.

🔗https://t.co/GevzyudAHe#MentalHealthMatters #CAMHSInterimReport pic.twitter.com/z7gSSJHghQ

— Mental Health Commission Ireland (@MHCIreland) January 23, 2023

Mr McCallion said Camhs continued to manage capacity through waiting list initiatives, with a focus on prioritising urgent referrals.

“However, we recognise that some people are still waiting too long for access to services, either in primary care or in Camhs services,” he added.

“We have seen significant increases in demand for all our youth mental health services further adding to the waiting list in some areas.

“There has been a significant investment in youth mental health services and Camhs over a number of years to meet increased demand and to improve services for children and young people with mental health difficulties.”

Mr McCallion emphasised that the report had also highlighted that many young people and their families had received excellent care and treatment.

He moved to assure committee members that concerns raised by the commission on specific cases had been taken “very seriously” and had been “promptly and comprehensively addressed”.

The commission had also recommended that the HSE undertake a clinical review of open cases not seen within the previous six months and also those who have been prescribed neuroleptic (antipsychotic) medication.

“This review is now under way in teams across the country and will provide assurance that these children and young people are receiving appropriate care, reflective of both their current and future needs,” said Mr McCallion.

“Those impacted by this review, will be contacted directly by the relevant Camhs team, and this process is targeted for completion by end of May this year.”