Concerns raised over impact of year-long child psychology waiting lists

Government announced a funding injection of €4 million designed to combat waiting times

Minister of State for Mental Health Mary Butler said she has been “acutely aware and concerned” about the waiting list. Photograph: Dara Mac Donaill

Minister of State for Mental Health Mary Butler said she has been “acutely aware and concerned” about the waiting list. Photograph: Dara Mac Donaill

 

Child mental health experts have warned that psychology waiting lists of over a year are having a detrimental effect and often needlessly exasperating problems.

On Wednesday, the Government announced a funding injection of €4 million designed to combat waiting times, particularly for those under the age of 18 that have been ongoing for years.

In June, the Dáil heard that over 10,000 people were awaiting primary care psychology appointments over half of whom were on the list for over a year, the “vast majority” children.

Primary care is the first step in the treatment process, accessed via GP referrals and often used to assess relatively minor anxiety or mood related issues.

“Anybody who has any kind of problem, the longer they wait, the greater the risk that that problem becomes more chronic,” said Gary Donohoe, Professor of Psychology at NUI Galway. “You catch something early and it takes less time generally to resolve the issue.”

Of further concern with younger age groups is that children are at a critical development stage, cognitively, socially and emotionally.

“It then becomes catastrophic if you leave them on a list for more than a few weeks.”

Dr Trudy Meehan at the Centre for Positive Psychology and Health at the Royal College of Surgeons in Ireland (RCSI) had previously treated young patients at the Child and Adolescent Mental Health Service in Wexford, in cases where they could not access primary care due to a two year waiting.

“You end up seeing an increase in self harm and serious anxiety and depression,” she said of the consequences of delayed service access. Because problems can accelerate - typically anxiety around school or family issues - children often end up requiring psychiatric diagnoses.

“We can’t have waiting lists at primary care. We know that early intervention is essential.”

Announcing the funding, Minister of State for Mental Health Mary Butler said she has been “acutely aware and concerned” about the waiting lists, particularly for younger people and children - as of last March, almost 5,300 were waiting more than 12 months for a first appointment.

The HSE said the funding would enable it to implement “a number of initiatives to increase access to primary care psychology within the community”, while the Minister said further long-term solutions were required.

However, according to Dr Kieran Moore, specialist consultant paediatric psychiatrist at Crumlin Children’s Hospital, there are wider systemic issues with how children’s mental health and illness is addressed.

He believes children should be assessed and treated according to clinical need, and said that unlike in other areas of medicine such as oncology, there are no defined treatment pathways in the area.

“I would insist that people actually see patients and don’t dump them onto other services,” he said.

“It seems to be acceptable that people are left on waiting lists and there is no accountability…managers in this country are managing systems they know nothing about.”

The US Centers for Disease Control and Prevention (CDC) defines adverse childhood experiences, those that often lead children and their parents to seek out help, as potentially traumatic events including violence, neglect, abuse and loss.

They can have lasting, negative effects on health and wellbeing, and can increase the risk of injury and a wide range of chronic conditions such as cancer, diabetes and heart disease, as well as suicide.

Raising the protracted waiting times in the Dáil recently, Sinn Fein TD Mark Ward challenged Ms Butler on the potential damage.

“Can the Minister of State imagine the regression in people’s mental health that can happen in a year?” he said. “Can the Minister of State imagine the impact this can have on a family over a year?”