The number of children waiting for a mental health appointment in West Clare has increased seven fold in the last year.
That’s just one of the findings of the Mental Health Commission’s latest annual report into the provision of Child and Adolescent Mental Health Services in Clare’s Community Healthcare Organisation Area.
The Mental Health Commission’s report was one of nine published today into Community Healthcare Organisations across the country.
The region of Clare, Limerick and North Tipperary comprises CHO 3 and contains six CAMHS teams serving a population of over 90,000 under 18s.
The current CAMHS teams in this county consist of East and West Clare who both operate from the Quin Road Industrial Estate in Ennis.
At the time of inspection last June there were twenty clinical staff sharing five clinical rooms and at the site and the report found that there was a shortage of available space, while there was no designated area to assess children with eating disorders.
Additionally the inspectors found that the East Clare Team had no staff trained in Family Behavioural therapy and there was no dietician on site.
The reported also cited that Clare parents generally had negative feedback concerning the state of the building.
The report also noted that the panic buttons in the Ennis facility did not work at the time of inspection.
The inspection also assessed the number of patients on waiting lasts between June of 2022 and February this year.
The CAMHS teams at East Limerick, West Limerick and Central Limerick all saw an average fall of 28%.
However in the same timeframe the number of children on a waiting list in West Clare saw a seven fold increase rising from 12 to 91.
The number of patients in East Clare on a waiting list meanwhile jumped from 30 to 43.
Across CHO 3, the average wait time for patients for referral to assessment was over 40 days in the case of Deliberate Self Harm, but less than five days in the case of suicidal intent.
Overall, 24 areas of concern were identified in CHO 3 ,which was the highest total nationwide.
The concerns included that no out of hours emergency care was available to patients and as a result referrals were put on hold until the consultant physiatrist returned.
At one unnamed CAMHS facility in the MidWest, ten dangerous occurrence incidents were reported in the space of a month.
The report also found that one child waited over four days at the emergency department in UHL to be seen, while ongoing shortages of staff and a high staff turnover rate across all CAMHS teams in the region were also noted.
The Deprivation Index meanwhile which is often used by the HSE to support decision making found that Clare was the 8th least deprived county nationwide.
Areas are assessed based on rates of Unemployment, Low social class, Local Authority rented housing and car ownership.
Limerick City, meanwhile was deemed to the most deprived city in the country, ranking 34th.
Responding to a query on today’s report from Clare FM, HSE MidWest Community Healthcare stated that The delivery of a high-quality CAMHS service to the children and young people of Clare, Limerick and North Tipperary is a priority and that significant investments have been made in the service.
The actions taken recently include increasing The number of -registered Consultant Psychiatrists in the Mid West to 6.2 Whole-Time Equivalent (WTE), up from 3.6WTE in January .
An additional CAMHS Team is in development for the Mid West region meanwhile which will bring the total number of CAMHS teams in the region to seven.
You can read the full report here
Following a Clare FM query, MidWest Community Healthcare issued this response.
HSE Mid West Community Healthcare welcomes the publication today (Thursday, August 31st, 2023) by the Mental Health Commission (MHC) of its report into Child and Adolescent Mental Health Services (CAMHS) in the Mid West. HSE Mid West Community Healthcare has engaged with the MHC throughout its examination of CAMHS, including during their inspection in the Mid West in June 2022. Throughout this process, and before it commenced, HSE Mid West Community Healthcare initiated a series of service improvements within to enhance the CAMHS service and improve the experience of children, young people and families in the Mid West. The delivery of a high-quality CAMHS service to the children and young people of Clare, Limerick and North Tipperary is a priority for HSE Mid West Community Healthcare. We have made, and are making, significant investments in the service, including:
- The number of CAMHS-registered Consultant Psychiatrists in the Mid West has increased to 6.2 Whole-Time Equivalent (WTE), up from 3.6WTE in January 2022. A further consultant post has been approved and recruitment efforts are ongoing.
- Since the beginning of 2022, a total of 16.6WTE have been recruited across Mid West CAMHS. This includes additional staff in areas including Consultant Psychiatrists, Advanced Nurse Practitioners, Social Workers, Occupational Therapists, Speech and Language Therapists and support staff. This has resulted in an improved CAMHS service in the Mid West.
- A new consultant-led multidisciplinary regional CAMHS Hub is under development. This is an alternative model to providing inpatient care, involving treatment at home or in a day hospital, and is designed to meet the needs of existing CAMHS service users with complex needs from across the Mid West. A number of staff for this service are already in post, and additional recruitment is ongoing.
- An additional CAMHS Team is in development for the Mid West region. This will bring the total number of CAMHS Teams to seven.
HSE Mid West Community Healthcare acknowledges deficits in the provision of CAMHS and apologises to children and families who have not received the standard of care that they or we expect. We are continuing to progress a targeted series of service improvements in Mid West CAMHS. The benefits of these service improvements are shown in the Mental Health Commission’s Independent Review of CAMHS (published July 2023).
This report’s findings include that:
- Mid West CAMHS now has the highest provision of Consultant Psychiatrist staffing of any Community Healthcare Organisation (CHO) when compared to the recommendations of A Vision for Change. The report also notes strong levels of staffing among Non-Consultant Hospital Doctors, Nursing Staff, Psychologists, Social Workers and Occupational Therapists.
- Mid West CAMHS reports some of the shortest wait times from when a young person is referred to the service, until they are assessed. Mid West CAMHS has the lowest wait time for young people referred for an assessment relating to eating disorders, and shorter-than-average wait times for all of the other main reasons for referral to CAMHS (depression, ADHD, anxiety).
- Mid West CAMHS accepts 79% of children and young people on their first referral to the service from their GP, the joint-highest acceptance rate of any CHO area.
Further benefits of these investments can be seen in the overall reduction in waiting lists across Mid West CAMHS. The total numbers waiting for an initial CAMHS assessment have dropped by 21% since the Mental Health Commission’s inspection in June 2022, and 16% since February 2023 (also referred to in the MHC report). This progress would not have been possible without the commitment of staff working in the CAMHS Teams. HSE Mid West Community Healthcare remains committed to further improving the CAMHS service for the benefit of children and young people in Clare, Limerick and North Tipperary. Any parent or guardian with a concern or query about their child who is currently attending CAMHS should contact their child’s team directly.
