Camhs: safety is everyone’s obligation

Sir, - Separate reviews of Child and Adolescent Mental Health Services (Camhs) before 2022 conducted by Dr Sean Maskey (South Kerry) and Dr Colette Halpin (North Kerry) raised significant concerns regarding diagnoses and treatment, in particular prescribing and medication safety in both regions, but also on deficiencies in many areas of the services.

Professor Fiona McNicholas is right to highlight the use of appropriate, evidence-based and safe prescribing of psychopharmacological treatment in children is a key treatment option in Camhs. Medication, however, is only one of many essential components in the treatment of childhood mental disorders and should be delivered as part of an evidence-based, multidisciplinary, and individualised care programme. These programs should include timely access to psychological therapies from multidisciplinary team members.

The substandard care offered in north and south Kerry was also a result of systemic failures in resourcing and governance at local, regional and national levels, and deficits in multidisciplinary team provision and governance, contributing to the lack of therapeutic availability and the imbalance of medication prescribing compared to Camhs nationally. Harm avoidance is not merely the obligation of clinicians and allied health professionals at the front line, but also of those who manage and resource services to meet the needs of the people it serves.

Accountability is critically important, in relation not merely to prescription of medication and other treatments, but also at senior HSE management and Government level to ensure adequate resourcing, appropriate governance structures and operational procedures are offered as standard. Anything less should be non-negotiable so that children in Camhs care nationally can receive the optimal treatment that they deserve, and so that trust can be restored. – Yours, etc,