Mental health service delays highlighted

Almost of fifth of children and adolescents with mental health problems have to wait more than six months to see a mental health…

Almost of fifth of children and adolescents with mental health problems have to wait more than six months to see a mental health professional, a new report shows.

In the year to September, some 7,651 new cases were seen by the 55 HSE community child and adolescent mental health teams across the country.

All cases are screened on the basis of urgent need. Some 47 per cent of new cases were seen within one month; 22 per cent within 3 months; 12 per cent between three and six months and 9 per cent between six and 12 months. Ten per cent had waited more than a year.

The HSE's annual report of child and adolescent mental health services also shows the number of children on HSE waiting lists on September 30th 2010 fell by 9.5 per cent to 2,370, compared to the previous year.

Some 396 children (17 per cent) on waiting lists had waited more than 12 months and 610 children (26 per cent) had waited between six and 12 months. HSE south and HSE west regions have the longest waiting lists with more than a quarter of children and adolescents waiting more than a year for an appointment.

The report says staffing levels in the child mental health area have increased by 8 per cent this year. But it warns "significant additional resources" will need to be invested in services to meet targets set in the Government's strategy for mental health services A Vision for Change, which was published in 2006.

An in-depth review of 6,950 cases seen during the month of November 2009 found fears of self harm or suicide was recorded as a reason for referral in 22 per cent of the new cases seen.

The top five reasons for referral for all under 18 year olds are: attention disorders 33.1 per cent; anxiety disorders 16.1 per cent; autistic spectrum disorders 10.7 per cent; depressive disorders 8.8 per cent; and behavioural problems 8.6 per cent.

In the 15- to 17-year-old age group deliberate self harm accounted for 6.2 per cent of presentations while eating disorders accounted for 5.6 per cent of presentations.

The vast majority of the 6,950 cases in the one month survey period involved children or adolescents who had already been seen by the child and adolescent mental health service. Just 10 per cent were new cases. Adolescents aged 15 are most likely to be attending community mental health services followed by children aged 10 to 14.

Boys accounted for 67.9 per cent of all cases presenting to the mental health services.

A Vision for Change  sets a goal of establishing 99 community teams across the country and sets recommended staffing levels across all mental health services. The report warns "significant additional resources" are needed and systematic national and regional planning is necessary to provide trained personnel and infrastructure.

The report estimates the decision to extend child and adolescent services from 16 to 18 years "doubles the cost of providing the service".

In 2009 there were 367 admissions of children to in-patient units, 58 per cent of admissions were to adult inpatient units. No child under 16 years of age should be admitted to adult units under a new code of practice. Next week, this code will extend to all children under 17 years.

The report shows staffing levels have increased by 8 per cent this year to a staffing level of 456 full time positions. This is 70 per cent of the recommended level in vision for change.

The report was launched today by HSE chairman Dr Frank Dolphin at the opening of a new 20 bed child and adolescent mental health services inpatient unit in Galway.