Fears staffing crisis at CAMHS worse than thought as targets based on outdated census data

There are fears that a recruitment crisis in the Child and Adult Mental Health Service (CAMHS) may be worse than originally thought as staffing targets are based on outdated figures.

A damning interim report on the state of CAMHS, published by the Mental Health commission this week, found that every CAMHS team in the country was “significantly below” recommended staffing levels, and some had less than half the staff they were recommended to have.

Staff shortages were blamed for long waiting lists and the lack of ability of some teams to carry out therapeutic interventions for children.

But the current recommended staffing levels are based on population figures from the 2016 census. The 2022 census of Ireland established that Ireland’s population had exceeded 5.1 million

Sinn Féin spokesman on mental health Mark Ward said he was calling on Heath Minister Stephen Donnelly to carry out an urgent report to set out “recommended minimum staffing levels for CAMHS”.

“We need to have something to aim for, at the moment we haven’t got anything to aim for,” Mr Ward said.

The HSE’s current national mental health policy, Sharing the Vision, does not recommend any minimum staffing requirements.

To establish how well- or poorly staffed CAMHS was, the Mental Health Commission relied on the framework in the previous mental health policy, Vision for Change, which was published in 2006. Mr Ward said he believed this was dramatically outdated.

“We need to set updated recommended minimum staffing levels, and we need to know how far from that we are. It needs to be done,” he said.

Concerns about poor staffing and recruitment for CAMHS come as the number of children waiting more than a year for their first appointment is the highest it has been in at least five years.

According to the most recent figures available, there were 579 children across Ireland waiting more than one year for their first appointment with CAMHS last November.

This is more than double the 221 children who were waiting more than one year in November 2021. The figure for the same month in 2020 was 242, and in 2019 it was 226. In November 2018, there were 295 waiting more than one year for their first appointment.

Dr Anne Keogh, the president of the Psychological Society of Ireland, said that those working in CAMHS wanted a “much more responsive” system for families.

“The idea that any family is told that their wait will be eight months, six months, three months, a year, two years,” Dr Keogh said.

“They are presenting to a service for children with moderate to severe mental health problems.

“That means that the mental health problem that the child is presenting with is getting in the way of a normal life, from a moderate to severe degree. They are not doing what a normal child would do.

“You cannot wait for that. It’s not acceptable. Parents can’t wait, kids can’t wait, the people delivering the service don’t want there to be a wait.”

John Church, the chief executive of the Irish Society for the Prevention of Cruelty to Children (ISPCC) said he believed there were children on CAMHS waiting lists who “should not be there”.

Mr Church said he believed that more talk therapy should be made available sooner to children who are experiencing symptoms of anxiety and depression.

This view was endorsed by some CAMHS staff, who did not wish to speak on the record. One said they believed that well-meaning GPs, who were anxious to get help for children with mental health difficulties, were using a “scattergun” approach and referring patients to a number of different services at the same time, such as CAMHS and Jigsaw.

They added that if earlier mental health interventions were more readily available, less children would need more acute care.