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IRELAND’S PSYCHIATRISTS HAVE issued a “critically urgent” call for a major overhaul of the mental health service for children and young people.
CAMHS (Child and Adolescent Mental Health Services) provides assessment and treatment for young people up to the age of 18 who are experiencing mental health difficulties.
The College of Psychiatrists of Ireland has today called for “major reform of the management and governance of CAMHS” and has published a policy document outlining changes it wants to see.
It said the current governance of CAMHS has “serious deficits”, such as a “lack of clarity as to whom responsibility for action lay between local, regional and national governance structures”.
This “ineffective governance” is also contributing to a failure to manage risk, a failure to fund and recruit key staff, and a failure to provide standardised models of care across the country.
The College of Psychiatrists of Ireland is the professional and training body for psychiatrists in Ireland.
The move is an unusually strong criticism of CAMHS, but the College of Psychiatrists of Ireland said that “trust has been lost in CAMHS” and that new governance and management structures are required as a “priority” to ensure a “high-quality service”.
Dr Patricia Byrne, Chair of the Faculty of Child and Adolescent Psychiatry at the College of Psychiatrists of Ireland said that reform of CAMHS is “critically urgent”.
She noted that CAMHS is “under-resourced, under pressure, and under-performing – and if the recommendations are not implemented, this will continue”.
At a media briefing on the policy document, it was noted that it is “very difficult” to recruit staff, given a recruitment freeze last year and as a result of the pay and numbers strategy which replaced the freeze.
This strategy stated that the employment ceiling in the HSE would be capped at the December 2023 numbers.
Byrne noted that some teams are “seriously understaffed”, and that there had been a failure to fund and recruit key staff.
She also warned that if the recommendations are not acted upon, more young people will be on waiting lists, and “more staff will end up burned out, working in a system not fit for purpose”.
She noted that the damning Mental Health Commission report on CAMHS published in 2023 “identified national deficits in team staffing and lack of minimal required resources to facilitate service delivery”.
The report found that the State cannot provide assurances that children have access to a safe, effective and evidence-based mental health service.
It also found that many children and young people end up “lost” in the system; in one catchment area alone, there were 140 “lost” cases within the local CAMHS team.
Byrne said the report highlighted a “crisis” in CAMHS and that “ineffective governance in some areas is contributing to an inefficient and unsafe” service.
The College of Psychiatrists said this 2023 report details failures in governance at a national and regional level, including insufficient funding and resourcing of CAMHS, serious deficits in digital infrastructure, and chronic and ongoing understaffing.
“Sadly, this has resulted in negative impacts in service experiences for young people and families who require our services, and for the front-line staff trying to deliver care,” said Byrne.
“As such, a major reform of the service is of critical and unparalleled importance to the wellbeing of those patients and their loved ones.”
Elsewhere, the psychiatrists also warn about a “reliance on medication”, without the required therapy to go alongside it.
While Byrne said medication will always be used in line with good practice and governance, she cautioned that some young people may only be able to access medication because of the long wait lists for therapeutic support.
Among the key recommendations within the policy document published today is for all staff working in CAMHS to receive specialist CAMHS-specific training to ensure optimal standards of care.
It also calls for specialist child and adolescent psychiatrists to lead each CAMHS team, as well as the creation of a new senior management role, the Clinical Service Manager (CSM), at a team and regional level.
This would be a senior role supporting and working alongside the consultant, with the ultimate aim of providing a “gold-standard service”.
This is a role that the College of Psychiatrists said it is “really strongly advocating for” and it would be a part-time senior management role to help deliver a “comprehensive, integrated child and adolescent mental health service across CAMHS”.
The CSM would be responsible for efficient management, coordination and administration of each specialist team.
The College of Psychiatrists said that investing in management will improve services and result in better outcomes.
The report recommends that all members of the CAMHS multidisciplinary team should have “clearly defined roles and be clinically accountable to the specialist consultant psychiatrist as the clinical lead”.
There is also a call for an “appropriate digital infrastructure”, noting that many psychiatrists are still using pen and paper.
The College of Psychiatrists of Ireland said this lack of proper digital infrastructure is “associated with governance failings, including patients being ‘lost to follow up’, loss of clinical records, and reductions in the quality of patient records”.
It added that this issue also “significantly increases workload on clinical staff performing administrative duties, further reducing the already under-resourced clinical capacity”.
Dr Lorcan Martin, the president of the College of Psychiatrists, said the recommendations outline “radical new governance and management structures”.
He added that they would “lay solid foundations for the development of a world-class mental health service of which we can all be proud” and he called on the government to “act urgently to implement the recommendations contained in the proposal”.
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SF should nominate someone who wasn’t in the IRA. Therefore the DUP can’t revert back to that point when Sinn Fein are screwing them. I would estimate a 20% increase in SF votes in the ROI if Gerry stepped aside. People don’t vote SF because of him. People vote for SF only for him too. But more votes without! Gerry kelly would be a disaster – playing into unionist hands
Gerry kelly shot a prison officer so he should be top of any sf list
How about sending Gerry Adams back up? He was never in the ‘ra!
@Sean O’Brien: Any credibility generated from appointing someone who was never in the IRA will be nullified as long as Gerry Adams remains in charge.
Agreed, well said.
@Cillian O’Gara: Gerry will hang on to power, until he becomes the next dictator/leader of Ireland and he may be in his 90′s by then like Brother Castro.
Your estimations are way off even if gerry went because they still glorify the provos. You would need a new generation who would state that the provos were bad plus everyone in the organisation admits their part and seeks forgiveness. On that day I may look at them differently
They really need to move towards candidates who have never been ‘blooded’, but realistically that probably won’t happen. The army council will still want their man in there.
What do you mean by blooded? Silly statement to make! The republicans who where willing to die for their beliefs says a lot about there determination to achieve their objectives! Personally I’d like to see someone like Conor Murphy or Gerry Kelly take the role someone who can carry the hardliners as well as the soft support to where it needs to go.
Now more than ever that’s important moving into a situation where there will be a hard border. A return to conflict in the north is a very real possibility given a hard border. Only those with a conflict past could dissuade young people from following that path.
Gear oil they were way more willing to kill others than die themselves. It’s not like they engaged in man to man combat, they planted bombs in public places with the intent to murder civilians, they targeted unarmed individuals and executed them, they shot unarmed gardai, the dragged mothers from their kids and tortures and executed them. What exactly were the beliefs that justified these acts?
@Gearoid, (sorry auto correct kicked in)
In one word freedom… the same acts that people like Michael Collins and Eamon de velera committed they didn’t throw teddy bears at their opponents. If the British where occupying your community land and telling you how to live my life, actively discriminating against you with regard jobs housing voting rights… then when you go to protest civilly they mow you down with machine guns! The troubles in Ireland never started with Martin McGuinness or the IRA if you knew your history you would know it started well before that with a colonial power not far from here.
How did mowing down civilians equate to freedom?
Jimmyjoe Wallace. Do you think the conflict was a one sided coin?
No Ray I never said that, but we are discussing sinn feint, are we not?
Jimmyjoe Wallace. Ok. So how many civillians did Sinn Fein mow down?
Ray you do know mcguinness has admitted to being in the Ira?
Jimmyjoe Wallace. Yes but we are dicussing Sinn Fein are we not?
Discussing
Ray if you refuse to see the connection between Sinn Fein and the IRA there’s no point engaging further with you.
@Jimmyjoe Wallace: As opposed to planting Weapons, on ” Nationalists “, or shooting people, going to Gaelic Games, yeah??? Which is what was done, by ” The British Army “, and ” The R. U. C. “!!!!!
Pádraig, both sides did appalling things. That’s the point, the political system up there would best serve all the people if it wasn’t each parties chief antagonist picked.
@Gearoid Mag Leannáin: You should know Gearoid that the Jimmyjoes of this world are embedded in a warm little cloud where they let others do the dirty work. Around 60% of the masses will sit back and do nothing (other than complain) in the face of aggression, 30% will take the political road and 10% will, in some form, fight fire with fire.
Gearoid sits firmly on his high horse, never to budge and absolutely useless.
@vNblxOSQ: In the grand tradition, oooops – JIMMYJOE sits firmly on his high horse…
Jimmyjoe Wallace. Are you saying that every member of Sinn Fein has a connection with the IRA?
No Ray I’m not which is why I agree with the original poster that SF should go with someone who doesn’t have an IRA past. But SF/IRA are two faces of the same movement. As regards me sitting on a high horde not getting involved, I’ll say this: I’m a democrat. Unlike mcguinness and Adams et all, I’ve always been a democrat who believed jaw jaw was better than war,war. I was involved in local politics for over twenty years and I also believe there was never any need for the levels of violence inflicted on northern Ireland, by all sides. It wasn’t worth the shedding of a single drop of blood, nevermind the wholesale slaughter that went on. Nothing was achieved that would not have been achieved through the democratic processes pursued by John Hume etc.
If you don’t know about ‘blooding’, you know nothing about the underbelly of life in NI over the past few decades. My point, to simplify it for you, is that they have a choice between picking a successor from one of tea murder gangs or picking one of the indoctrinated young clones who have never been blooded, ie made to kill somebody to prove their loyalty. My guess is that although one of the little clones would improve their ratings among normal people, the ‘army’ council will insist on keeping the perks of high office within their ranks.
John Mulligan. Methinks you are watching to many mafia movies.you gobsh!te.
Just like Micheal Collins did
I hope Michelle O’Neill gets the roll…while watching Michelle O’Neill speaking to Stormont last week alongside McGuinness on tv, I couldn’t help but notice she looked a bit nippy…certainly get me more interested in NI politics.
It might be a bit of a jump to go from IRA man to what looks like a Barbie pron star. She seems to be able to talk the talk but appearances can be everything to many people. They don’t bother me generally but I suppose it could make things more interesting in Northern politics.
Agree that Gerry Adams will have to retire at some stage when the members feel it is time. However, I don’t buy into the myth that there are hoards of Fine Gael & Fianna Fail voters out there who are just bursting to vote Sinn Féin after standing idly by for 50 years and actively harassing and persecuting Republicans during this time. They can stuff their 3rd preferences where the sun don’t shine..
The new leader was hand picked by Gerry Adams and Martin Mcguinness. (According to Adams) Not exactly the democratic process we are told Sf use to select their leaders.
@Cillian O’Gara:20% increase if Gerry goes…in your dreams.
In your nightmares
There is no point in using “whataboutery” if you are in a position of power or influence you just breed a whole new generation of bigots that’s why Arlene was completely wrong as DUP leader and Michelle is the right one to lead Sinn Fein.. We can’t keep looking backwards without ending up turning backwards. Not saying any side should forget “whataboutery” as a lot of people got hurt, but don’t use it for political gain.
Should a criminal record be a prerequisite?
So the army council meet on a Monday morning before they sign on. Good to know
Michelle O’Neill has got the job
No leadership contest ? Very democratic bunch
Why wouldn’t Gerry Adams run ?
They’re promoting the young’uns. Michelle O’Neill a shoe-in if you ask me. Why would Adams trigger a by-election and re-enter Northern politics when he has one of the safest seats in the Dáil. I think the only TD with a safer seat is Stephen Donnelly, and considering people like Adams and Enda Kenny brought running mates over the line shows that Donnelly could have brought someone over too.
I don’t think so. They should try to move on and break with the psychopaths but the army council will want to hold on to the perks.
What are you on about “run”. The selection of the new leader in the north was done by Adams & Mcguinness. There is not an open contest or selection process. Don’t be so naive
Joe Smith. There is not an open contest or selection process. And you know this how. Are you a member of SF perhaps?
No, I listened to gerry Adams an rte yesterday. ……….. Unless you have an alternative fact :)
Joe Smith. I have just read that interview by Gerry Adams. And nowhere in it does he say himself and martin have picked a new leader for the north.perhaps you have an alternative fact. Do share.
I don’t care what you read, I know what I heard him say, that he and Martin Mcguinness selected his successor last year. He said it on public airways so your alternative facts seem wrong.
Also if you are aware of some open selection process and Gerry lied, please tell us where, when and by whom the selection process did happen. I know you won’t be able to as for once I believe gerry so please, Stop spoofing
Joe Smith. I agree there is a spoofer here and it is not me perhaps you have some proof gerry and martin handpicked the new leader.not hearsay actual proof
Joe Smith. The president of Sinn Fein does not have the power to appoint or dismiss the deputy leader. So who is the spoofer. Hint look in the mirror.
For the last time Gerry Adams said in rte yesterday, “myself and Martin Mcguinness selected his successor last year.” If you have a problem with that take it up with SF. I see no reason to disbelieve Adams as I have heard nothing about people putting themselves forward for the job, have you ? If so share it please. If not an apology would be accepted
Joe Smith. Gerry Adams does not have the POWER to appoint a successor. Look up Sinn Fein policy and get back to me.
Well you better tell him, and you come back and tell me of I dreamt it and he didn’t say it, who ran ? How was the successor selected ? You can’t because I didn’t dream he said it…
I notice with all your rhetoric you have not pointed out when or where the selection process you believe is required happened. I wonder why
Joe I am not privvy to that in formation. But you do seem to be the only one who heard it.
Really, so it’s not an open process. Also you better get on to rte radio because they reported on the 1 o’clock news today that it was Adams and mcguinness that would make that selection. Educate yourself b4 trying to pull people up
People seem to be confused with ” Party Leadership “, and ” Stormont Leadership “. ” Party Leadership ” is dealt with EVERY YEAR, at ” The Árd Feis “, BY ALL MEMBERS!!!!!!!!!, and ” Stormont Leadership ” is a lot like the Portfolios / ” Minister Shadowing “, where ” Grassroots Members ” don’t ” have a say “, in it. We didn’t get a say, and won’t get a say in who became, or becomes ” Deputy First Minister “, or who became ” Minister “, just like we don’t get a say in who becomes ” Party Spokesperson “, and in my opinion, we shouldn’t!!!!! How many members of any of the other parties can say that they ” have a say “, in any of it??? I know that ” The Labour Party ” only have a contest, when there’s a challenge, or AFTER an Election, and that ” Fine Gael ” elect their Leader, through ” the Parliamentary Party “, WHEN THERE’S A CHALLENGE. I like the idea of Michelle, in the position. I don’t know what it is about her, that has me being of that opinion, but it ” just makes sense “. Maybe it’s because she’s done such a good job, in the two positions she’s held, since being elected. I also like the idea of Mairtín, as the choice. I think he did ” a fantastic job “, as ” Mayor of Belfast “, and is ” capable “, to say the least. I could mention any of the other ” contenders “, and my reasons for them, but don’t think I need to.
I really think you have to have someone with a lot of experience because you dealing with very tough negotiations and one with very little experience would be swallowed up.
I like Ms O Neill she is photogenic. But I don’t like her anti family stance. Mr Murphy would probably be more “pro life”. But it has been said he was involved in the troubles- so that may not help him. Maybe Mr O Dowd might be best.
You have to admire the military discipline of SF….. New leader selected in secret and all members will support them….. No rows or leaks to media …All the other parties would love such discipline
@declanhanley: According to reports then Conor Murphy is the polar opposite of hardline DUP Arlene Foster and has been criticised in the past over his sectarian anti Protestant activity.
have your say