2,500 children left at risk by a lack of psychiatrists
More than 2,500 children who are in some form of mental health distress are on waiting lists to see a psychiatrist - hundreds of whom have endured delays of more than a year.
The harrowing wait for specialist care may be leaving some children, who are in severe emotional turmoil, at risk of self-harm or suicide.
Struggling community mental health teams for children and adolescents are under-staffed and some inpatient units for young people have had to close beds in recent months because of a lack of nurses.
New figures show 317 young people have been on waiting lists for at least a year with several areas particularly badly hit, including counties in the north west and south.
The spotlight on the obstacles to accessing care follows the tragic death of Milly Tuomey (11), from Templeogue in Dublin, who took her own life after speaking of having a death wish and being unhappy with her appearance.
She had an appointment to see a psychiatrist in a child mental health team on January 30 last year but died by suicide on January 4.
Asked to comment on the state of mental health services for young people yesterday, Brendan Kelly, professor of psychiatry in Trinity College, said: "Waiting lists always result in services being delayed and this is also the case in child and adolescent psychiatry in Ireland.
"This is attributable to a combination of staff recruitment and retention problems, increased awareness of mental health problems - which is good - and rising rates of distress and self-harm in young people."
Prof Kelly told the Irish Independent: "Hearing that someone is having thoughts about self-harm is very difficult. For most people, the first step to accessing care is to attend a GP or, in emergency circumstances, a hospital emergency department.
"But even before that, it is important to talk things through with the person in a supportive, compassionate and direct way."
He added: "There is no evidence that asking and talking openly about suicide increases risk. Always ask. Always talk."
He called for greater awareness of the risks young people face at home, in schools, and at extra-curricular activities: bullying, peer pressure, exam stress and increasing rates of self-harm.
"We need heightened awareness of this," he said.
Prof Kelly said that we needed to be aware that suicide could not be predicted in any individual case, so efforts to reduce suicide and self-harm needed to be aimed at all children, not just those who appeared to present a risk.
He said it was "too easy simply to blame social media. While social media has changed the way people interact, sometimes in negative ways, it also provides new ways to reach out and to connect, which are very positive".
Meanwhile, Professor John Hillery, of the College of Psychiatrists, stressed the need for children to be taught coping and problem-solving skills at school to try to help them respond to stress and prevent mental health problems.
It is estimated 115,000 young people have a mental illness and 23,000 have a severe, disabling problem.
The HSE said that all children referred to mental health teams were assessed and those who were urgent were seen as a priority.
There are currently 69 of the 79 recommended community teams in place.
Despite a net increase in staffing from 622 in 2010 to 842 in 2015, most teams across the country have only half the staff needed.
Staff shortages remain a problem, despite intensive recruitment efforts.
Those in need face a long wait
Among the 10-14 age group, 78 boys and 244 girls presented at hospitals after self-harm over the course of a year
115,000 children and adolescents have a mental illness
23,000 of these have a severe and disabling mental health problem
Just 69 of the 79 recommended mental health teams for young people are in place
Some parts of Dublin had no child psychologist for a period
The longest waiting times to see a psychiatrist are in the north west, Clare, Limerick, Cork and Kerry, Longford and Louth
The go-ahead has been given to recruit 120 assistant psychologists to triage children.