Report into CAMHS services in region published

A report published by the Mental Health Commission (MCH) into child and adolescent mental health services (CAMHS) shows there are currently 605 children and adolescents on the waiting list in Community Healthcare Organisation (CHO) 8 which includes Meath.

Details of waiting lists were included in the individual reports published into the CAMHS in each of the nine CHO areas of the Health Service Executive (HSE) and also included strengths, improvements, challenges and areas of concern.

The report found that the average wait time from referral to assessment in CH0 8 which includes Louth, Meath, Laois, Offaly, Longford and Westmeath is three to four months but can be as long as nine months for referrals querying ADHD.

Overall the report found no areas of concern in the CH0 8.

It is one of nine individual reports published today by the Mental Health Commission which have already informed a final report into CAMHS by the Inspector of Mental Health Services, which was published by the MHC at the end of July 2023.

On their own, each report provides an overview of the strengths within each CHO CAMHS service, the challenges they face, the quality improvements and initiatives that they have put in place, and any areas of concern identified by the Inspector and her team.

As part of the overall review, the Inspector and her team met with the area management teams, each of the CAMHS community teams, and reviewed clinical files in each team within each CHO. The Inspector and her team also spoke with families and young people who availed of the services, and other stakeholders.

The Inspector’s overall independent review into CAMHS, which she commenced in April 2022 - and included the publication of an interim report in January 2023 – was published on July 26, 2023, complete with 49 recommendations for the State.

Due to the seriousness of the concerns raised by the review, the Inspector recommended that a comprehensive strategy for CAMHS and all other mental health services for children be prepared; that the implementation of the report recommendations must be monitored by the MHC; and that CAMHS should be immediately and independently regulated by the MHC.

The report for CHO 8 which includes Louth, Meath, Laois, Offaly, Longford and Westmeath found no areas of concern. It identified 14 strengths in the service and eight areas of quality improvements and initiatives. A total of 18 challenges were identified within the services.

The number on the waiting list for CHO 8 in March stood at 605, the third highest of the nine areas. This was down from 664 in January. However, services within Meath saw an increase in numbers on the waiting list. In Meath South/Ashbourne, it went from 125 in January to 131 in March. Trim saw an increase from 112 in January to 115 in March, North Meath rose from 56 to 57 and the South Louth/East Meath area went from 50 to 58.

As part of the review, 159 files, which is approximately 10 per cent of the caseload accepted from 2021 onwards, were audited. The report found that the average age of young people in the sample accepted by CAMHS in the area was 14 years. The young people receiving a service were from six to 19 years of age.

The average wait time from referral to assessment was three to four months. A reasonable wait time from referral to assessment is considered to be three months or less. The audit found that 64 per cent of children/adolescents had a wait time from referral to assessment of three months or less and of those waiting three months or less from referral to assessment, 91 per cent waited approximately three months or less from assessment to treatment.

Among the top reasons for referrals were query in relation to ADHD, anxiety, eating disorder, and depression with the highest number of referral being "query anxiety".

Young people who were queried by their GP to have anxiety wait on average, four months from referral to assessment. Young people queried to have an eating disorder wait on average one month to be assessed. Young people queried to have depression wait on average two months to be assessed, while young people queried to have anxiety and depression wait on average three months to be assessed.

However, young people who were queried to have ADHD wait on average nine months to be assessed.

The report found that the wait time for children with ADHD for an assessment is lengthy and likely represents a “bumping down” the waiting list, as urgent or emergency referrals are assessed first.

"However, children with ADHD have disrupted education, with strained family relationships as parents try to manage their behaviour, and poor social interactions and relationships with peers. Assessment and intervention should not have to wait for nine months," the report added.

In terms of feedback from young people and their families, the report stated that most praised individual staff members and felt that their needs had been met during their time in CAMHS.

However, there were complaints about the length of waiting times for CAMHS, CDNTs, and primary care. They spoke about moving from one waiting list to another, and of having to seek re-referrals from GPs to CAMHS. There was confusion about the criteria for acceptance by CAMHS and immense worry about deterioration of their child’s mental health while on waiting lists.