More than 11,700 children and teenagers accessed child and adolescent mental health services (Camhs) last year by the end of November, 20 per cent above the demand the Health Service Executive (HSE) was expecting for the year.
A total of 11,703 children and teenagers were re-referred or newly referred to Camhs community teams in the year leading up to November, compared with an expected activity level of 9,338, according to data released by the HSE.
Meanwhile, 3,357 children were still waiting to access Camhs by the end of November – the highest such number since 2015, when there were 3,100 children on this list. Some 1,686 of these were “expected to be seen within three months”, the HSE said, while the wait time for the remaining 1,671 is unknown.
More than 6 per cent of those on the wait list (221 children) had been waiting more than a year to be seen, according to the HSE.
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The waiting list for appointments with the child and adolescent mental health services has been stuck at at least 2,500 for years. Camhs offers specialist clinical services to children and teenagers under 18 with moderate to severe mental health difficulties.
Among those who did access Camhs supports, 75 per cent were offered an appointment within 12 weeks, coming in just short of the HSE target of 78 per cent. Nearly 96 per cent of accepted referrals or re-referrals were offered a first appointment and seen within 12 months, said the HSE. Nationally, Camhs responded to 94 per cent of urgent referrals within three working days.
HSE statement
In a statement sent to The Irish Times, the HSE said Camhs waiting lists vary according to Community Healthcare Organisations (CHO), and while some areas have relatively short waiting lists, the wait time is longer in other counties. The availability of specialist clinicians, vacancies and difficulties in recruiting internationally all play a role in the length of wait times in different parts of the country, it said.
The wait for Camhs services also stems from capacity issues in other parts of the system, where young people may not receive early intervention and thus require more expert Camhs support, it said.
The HSE said CHOs were making efforts to “ensure no child is waiting more than 12 months” to be seen, but that an increase in population size and more referrals, alongside issues with staffing retention and recruiting, had made this challenging.
“Where there are recruitment gaps, Community Healthcare Organisations make significant efforts to fill positions on a permanent basis while also looking at the possibility of vacancies being filled on an interim or temporary basis in order to ensure the least impact on service provision.”
‘Not good enough’
Dr Ike Okafor, consultant in paediatric emergency medicine at Dublin’s Temple Street hospital, said the waiting list figures for both mental health services and more general hospital services were “not good enough” and that these delays could have grave, detrimental, long-term impacts.
“No child should have to wait more than six weeks to get any kind of healthcare intervention,” he said in December as part of the Irish Hospital Consultants Association #CareCantWait campaign. “Long waiting times are not just an issue for children’s physical or mental health. It’s about their social health as well; often they are not able to play with their peers, they’re not spending time in school and these are really fundamental parts of their lives.
“The pandemic has led to a massive increase in children presenting with acute mental health problems, especially eating disorders and self-harm. A system that was already under pressure, not just in hospitals but in the community, has suddenly gone into crisis mode,” said Dr Okafor.
“Children are waiting longer and longer to see psychologists and psychiatrists and that’s a problem.”