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'Mental health tsunami' as children struggle with lockdowns



Serious concerns: Professor Fiona McNicholas says sector is under-resourced to cope with the pandemic phenomenon

Serious concerns: Professor Fiona McNicholas says sector is under-resourced to cope with the pandemic phenomenon

Serious concerns: Professor Fiona McNicholas says sector is under-resourced to cope with the pandemic phenomenon

The number of children looking for psychiatric help for mental health issues soared when the lockdown restrictions were lifted last summer.

Paediatric psychiatrists have been describing the pandemic phenomenon as a tsunami which is expected to continue to rise, sparking concern that the HSE's chronically understaffed Child and Adolescent Mental Health Service (CAMHS) will struggle to cope with the surge.

Since July last year there has been a sharp rise in children presenting with mental health difficulties to children's hospitals and CAMHS.

Clinicians are seeing increasing numbers of distressed children presenting with conditions such as suicidal ideation, self-harm and eating disorders.

Cases of behavioural difficulties - linked to changes in routines and school closures - in youths with learning difficulties and autism have been seen by medical professionals, while calls to Childline, voluntary organisations and domestic abuse services have also increased.

New figures show the number of mental health presentations by children aged five to 15 years at the three paediatric emergency departments in the capital has shot up by 41pc from July to October last year compared with 2019.

This is in stark contrast to overall emergency department attendances to Children's Health Ireland, which encompasses Temple Street, Crumlin Hospital and Tallaght Hospital, which fell by 15pc in the same period.

Dr Therese McDonnell, who compiled the data at the Centre for Interdisciplinary Research, Education and Innovation in Health Systems in UCD, said it is a worrying trend.

"There are proportionally more girls turning up, with over 50pc of presentations happening out of hours, which is alarming as the out-of-hours mental health service is poorly resourced," she said.

"We saw 467 children present at these emergency departments with mental health conditions between July and October in 2020, up from 332 in the same period in 2019.

"The phrase 'mental health tsunami' has been used by some psychiatrists. They are concerned this is just the beginning."

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CAMHS has seen a similar jump in numbers at the Lucena clinics, which provide mental health services for a catchment area of 260,560 youths in and around Dublin.

Professor of Child and Adolescent Psychiatry at UCD School of Medicine, Fiona McNicholas, said there was initially a reduction in referrals to all five of the Lucena clinics in Dublin and Wicklow at the start of lockdown and over the summer months. But from September there has been a 50pc rise in referrals compared with the previous year, with rates in November increasing by 180pc.

She said it is unclear whether this reflected mental health difficulties not seen due to the initial stay-at-home lockdown orders, a deterioration in pre-existing conditions, depletion of resilience or new onset mental illness.

She said publicly available data is unavailable in Ireland which would be crucial for the examination of the profiles of new cases.

"There's a sense anecdotally by clinicians of referred cases being more urgent, clinically complex, with higher numbers presenting with suicidality, self-harm, and eating disorders," she said.

"We are coming from a position pre-pandemic where CAMHS services were recognised to be underfunded and under-resourced, access to mental health beds sub-optimum and huge gaps in out-of-hours specialist services."

She said the effect of the pandemic on the short-staffed child mental health sector "creates the perfect storm for staff burnout".

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