Mental Health Services Must be Safeguarded

“This Office is concerned with staffing problems in the Child and Adolescent Mental Health Services (CAMHS) which means that children experiencing escalating levels of stress and anxiety are often unable to access the emergency supports they need. It is crucial thatthe HSE addresses issues relating to the out-of-hours contracts of consultant psychiatrists to ensure that children and adolescents have access to the services they need, when they need them.” That’s the view of Dr Niall Muldoon, the Ombudsman for Children, as expressed in his 2017 Report, which was issued last Wednesday in tandem with ‘Take My Hand’, a report which highlights the views of young people in receipt of inpatient mental care.

Forty-eight hours prior to the publication of this report, the President of the College of Psychiatrists, Dr John Hillery (son of the late President Patrick Hillery) told the Family Carers Ireland Conference that he had to resign due to HSE inaction on addressing mental health service provision. Dr Hillery didn’t mince his words, stating: “The fact that we are still discussing these issues as needs rather than as facts is a disgrace. It is one of the reasons I resigned my clinical post earlier this year after nearly 30 years in the mental health and intellectual disability services as a trainee and consultant.”
His resignation, in addition to the news that three specialist consultant paediatric psychiatrists in the South East have also stepped down from their respective positions, is the latest alarm bell to be set off in our regional health system.

“Though Government ministers regularly communicate their intention for reform in the mental health services the current situation leads me to question the intent. Our structures lack governance. The HSE has no board and an acting CEO. The main policy on mental health services ‘A Vision for Change’ recommended a leader in this area but recently the last CEO absorbed the Mental Health Division into a bigger grouping thus removing the focus at the necessary high administrative level from mental health.”
This week’s edition features first hand testimony from a 15-year-old Waterford city girl who attempted to end her life by suicide a handful of months ago.

The experience of interaction with this strand of the health service, as relayed to us by both the girl in question, heartily suggests that the system does not engage with suicidal adolescents or their children in either a comprehensive or holistic manner. The Joint Oireachtas Committee on the Future of Mental Healthcare, established in July 2017, has called for “the development of a realistic plan and timeframe for the provision of 24/7 crisis intervention teams nationally”. The Committee has also recommended addressing capacity within CAMHS, improving the level of cohesion between primary care and mental health services along with promoting talk therapies and “signposting services that are available in the community”. These points echo what both ‘Anna’ and ‘Jane’ told us during an extensive interview on their experience of the mental health system.
Dr Hillery justly queried “why is there money for less important issues such as Metrolink”, adding: “We need transparent, simple governance of our health service as regards financing, planning and delivery. The multiple layers and cross responsibilities, a diagram of which resembles a Jackson Pollock painting, have to be reduced into a simple effective model with allocated decision making and accountability.” Reports may well be necessary, but nothing speaks louder than clear, decisive and suitably resourced actions. It’s the least our children deserve.

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