Most young people with mental health issues are referred for treatment by themselves or their parents

Fewer than one in five required more substantial psychological help outside of community-based early intervention services, study in west of Ireland finds

The vast majority of young people with mental health issues are referred for initial treatment by themselves or their parents, a study in the west of Ireland has found. This is far more than are referred by doctors or schools.

The study, focused on people between the ages of 12 and 25, also found fewer than one in five required more substantial psychological help outside of community-based early intervention services, suggesting the latter is a model that could alleviate pressure on oversubscribed HSE care.

Gary Donohoe, professor of psychology at the University of Galway, who led the research, said it was not clear why 78 per cent of all referrals were from those in need of help or their parents.

“In my experience GPs are very good at being sensitive to the needs of young people and their families so I don’t think the problem is there,” he said.


“The evidence that we have to draw on suggests that when young people and their families experience a difficulty . . . it’s extraordinarily difficult for people to know where to turn.”

The study used a sample of 1,184 participants who attended the HSE-funded Mindspace Mayo, a youth service similar in approach to the national organisation for youth mental health Jigsaw, which places much emphasis on “signposting” options.

Parents accounted for 40 per cent of referrals and self-referrals by young people were at 38 per cent. Other less common avenues included schools and teachers, guidance counsellors and GPs.

Almost one in five (17 per cent of the sample) required more specialised care typically provided by the Child and Adolescent Mental Health Service (Camhs).

In a recent interview, HSE chief executive Bernard Gloster said Camhs was under great pressure. Earlier this year, there were 4,450 people on its waiting list.

The study, published in the Irish Journal of Psychological Medicine, noted the most frequent reasons for referral were mood and anxiety-related issues.

“A majority of the problems of young people are just the normal understandable difficulties experienced coping with life; the stuff that makes you anxious, the stuff that you get down about,” said Prof Donohoe.

“The one in five who go on to Camhs, they’re by and large the ones who have the kind of problems that require more specialist care.” This includes psychosis, eating and mood disorders.

“You’re supposed to only get on to the second tier of a Camhs or an adult mental health system [Amhs] when you need it either because of the severity or the complexity of the problem.

“We’ve been kind of working in a vacuum up until these [early intervention] services started to be invested in by the Irish Government. If you talk to colleagues in Camhs and Amhs, they would say there’s just such a flood of people coming into the service and you’re trying to triage the people who really need to be there from the people who don’t.”

Females were more likely to self-refer than males (42 per cent compared with 32 per cent), while GP referral was slightly more prevalent among males than females (6.3 per cent and 4.8 per cent). Participants received an average of six sessions of therapeutic support.

According to the World Health Organisation, psychiatric disorders are the leading cause of disability for young people between the age of 10 and 24.

In Ireland, the study notes, 18.5 per cent of the population was recorded as having a mental health disorder in 2016.

Donohoe said early treatment for issues such as anxiety is especially important to prevent it escalating.

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Mark Hilliard

Mark Hilliard

Mark Hilliard is a reporter with The Irish Times