Unwell young people ‘did not meet the strict eligibility criteria’
More than 7,600 children referred by GPs to the HSE’s Child and Adolescent Mental Health Service (CAMHS) last year were turned away because they did not meet strict criteria for eligibility.
In the first four months of this year, 3,003 children and adolescents were deemed not suitable for the service, figures show.
The data has been revealed amid ongoing concerns about the ability of the service to cope with the level of demand from children and teenagers in various levels of mental distress.
The figures – released by the HSE to Sinn Féin TD Mark Ward – show how children can be caught in a trap as
GPs strive to secure specialist care amid long waiting lists
for mental and disability services.
In response, Tony McCusker, general manager in HSE mental health services, said the CAMHS operational guidelines aimed to ensure the delivery of mental health teams was carried out in a consistent and transparent manner nationally.
“When deciding if a child or adolescent needs to attend CAMHS a number of factors are considered,” he said. “These include consideration of the child or adolescent’s clinical presentation, their level of social and family support and the availability of resources and treatment options at primary care level or within community networks.
“It is the role of the CAMHS team to decide if the child or adolescent reaches the threshold for community CAMHS – whether their mental health disorder is moderate to severe.
“Types of referrals accepted to CAMHS moderate to severe mental health disorders are often described on a continuum of severity ranging from mild to moderate to severe.
“A number of factors are taken into account when defining whether someone has a moderate to severe mental disorder.”
In practice, the term “moderate to severe” means the mental disorder is severe enough to cause substantial distress to the child or their family or others.
“The child or adolescent would have a significant impairment in functioning in various aspects of their life including development, family relationships, school, peers, self-care and play or leisure activities,” Mr McCusker said.
“It is also important to note that not all children and adolescents will fit neatly into a diagnostic category.”
He said types of referrals not suitable for children or adolescents were where “their difficulties are related to learning problems, social problems, behavioural problems or mild to moderate mental health problems”.
“There are many services available to respond to these issues for children and adolescents, for example HSE Primary Care Services, HSE Disability Services, Tusla, Jigsaw, national educational psychology services and local family resource centres,” Mr McCusker said.
However, there are already waiting lists for these services.
He said CAMHS did not accept children where there was no evidence of a moderate to severe mental health disorder present.
Children with an intellectual disability should be referred to the HSE social care and HSE disability services for the diagnosis and treatment of intellectual disability.
However, those children or adolescents with a mild intellectual disability with moderate to severe mental disorder were appropriate to be seen by CAMHS, he said.
Those who required assessments or interventions relating to educational needs should be referred to the Children’s Network Disability Teams or the National Educational Psychology Service, Mr McCusker said.