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Mentally ill children and adolescents face ‘inhumane’ delay for treatment

Stigma around the issue in Ireland contributes to the chronic underfunding of mental health services and puts lives at risk, says psychiatrist Dr Yvonne Begley


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Children and teenagers with mental illness are suffering unnecessarily because of chronic under funding of mental health services for young people, according to consultant psychiatrist Dr Yvonne Begley.

Stigma surrounding mental illness persists in Ireland and has contributed to the failure to ensure adequate staffing and resources for Child and Adolescent Mental Health Services (CAMHS), she said.

Long waiting lists of young people needing treatment for mental illness ultimately “put lives at risk”.

A failure to provide timely treatment for mental illness in children and adolescents can result in some dying as young adults due to substance abuse, dangerous behaviour, eating disorders, or suicide said the psychiatrist, who works with young patients in the State-funded CAMHS system.

Earlier this year, more than 2,700 children and young people were on waiting lists for CAMHS.

It is “inhumane” that young people remain on waiting lists for long periods while their parents grow increasingly desperate for them to receive the expert care they need.

“Our services need to beresourced properly to save lives,” she said.

The Limerick-based consultant said the Vision for Change report in 2008 laid out a blueprint for CAMHS services nationally, including services in the mid-west. It recommended a paediatric liaison consultant psychiatrist and team at University Hospital Limerick, but none was appointed.

She added that many children being treated for physical illnesses in hospitals have a mental health component.

“It often happens there is a developmental challenge and the child can’t meet it because there is family trauma. So a child ends up with physical effects because of psychological difficulties.

“If you have a functioning paediatric liaison team in a hospital, you can deal with problems that could be psychologically entwined. It can be a complex mix of mind and body. And you can save on budgets because you dealt with the real issues.

“CAMHS has only half the number of staff proposed for the region in Vision for Change. A 20-bed unit for young people with mental illness and a day unit in Limerick failed to materialise,” she said.

Services for children and adolescents receive a small proportion of the overall funding for the treatment of mental illness and there needs to be a bigger proportion of those funds allocated for young people.

Ireland still does not have a 24-hour, seven-days-a-week emergency service for mentally ill young people in crisis. The amount spent in Ireland treating children and teenagers with mental illness is far lower than in many other European countries.

Dr Begley’s team found that the Covid pandemic had a negative effect on the mental health of many children.

“My team are prioritising anxious children partly because Covid has produced a lot of anxiety. Some of the children have developed obsessive compulsive disorders, which is a form of severe anxiety. Some developed eating disorders, becoming anorexic. Some of this was due to lockdown and heavy usage of social media where girls can see all these skinny models,” she said.

Sadly, there is still an element of stigma and shame attached to mental illness in Irish society.

“One of the worst things is that people are still blamed for mental illnesses. And people are blamed for their children’s illnesses, which is why there is so much denial and stigmatising.  

“They think ‘it’s your own fault’ or ‘it’s your mum and dad’s fault’. Or else, someone else’s fault. That blame doesn’t help anyone.”

CAMHS also needs much more investment in infrastructure, management, and support staff including secretarial services to free up time to allow professionals to spend more time treating patients, she said.

Meanwhile, Mental Health Reform, a group campaigning for more resources to treat mental illness, in its pre-Budget 2021 submission, pointed out that 2,730 children were waiting for specialist help from CAMHS.

It stated that this is a crucial time in their personal, emotional and psychological development which is impacted by the lack of services available to them.

In March 2021, there were over 10,000 people on a waiting list for a primary care psychology appointment, the majority of whom are children and adolescents. Increasing staffing levels in primary care would help to divert referrals from CAMHS and improve mental health outcomes for children and young people. The lack of round-the-clock crisis intervention for mentally ill young people means that emergency departments are often the only resort, which can be very distressing for those who need help.

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