Prescribing practices and guidelines focus of Camhs audit

Inquiry follows report of ‘risky’ treatment of children in south Kerry

An audit of child and adolescent mental health services (Camhs) is to examine prescribing practices and operational guidelines across all diagnoses.

The audit will also cover all Camhs teams nationwide, Minister of State for Mental Health Mary Butler has confirmed.

The audit was ordered in the wake of revelations at South Kerry Camhs, after a report found hundreds of children received “risky” treatment from a doctor and significant harm was caused to 46 of them.

The risks involved in the treatment by the junior doctor included sleepiness, dulled feelings, slowed thinking and serious weight gain and distress.


In response, the Health Service Executive agreed to commission an independent review of medication practice across all its Camhs teams, as well as an audit of compliance with operational guidelines and a qualitative study of service users.

However, the HSE said it would begin its audit by focusing on Camhs cases involving young people with ADHD (attention deficit hyperactivity disorder) before potentially broadening the scope of the audit later.

Terms widened

This prompted criticism from the Mental Health Commission, which said the HSE had narrowed the terms of the planned audit, as well as Opposition politicians. Following discussion between Ms Butler and the HSE, it was agreed that the audit would cover all diagnoses.

Ms Butler on Thursday said the HSE was wholly committed to implementation of all 35 recommendations in January's report by a group chaired by Dr Sean Maskey, "as well as the additional actions they will undertake at my request".

"I requested an audit of prescribing practice and, following intensive discussions with the HSE, I am pleased to report that an expert team, chaired by Dr Collette Halpin, has been established."

Dr Halpin’s team is finalising the process and methodology to be followed, and expects to report in the last quarter of this year, she said.

Separately, proposals for the audit of compliance with operational guidelines are being “procured”, she said. Once chosen, the person carrying out this audit will be asked to complete it within six months.

‘Ethical approval’

“On the qualitative research into Camhs experiences, work is at an advanced stage. HSE is engaging with an academic partner and they are at an advanced stage. The research will require ethical approval. It’s expected that this work can be completed within six months of confirmation of approval.”

Ms Butler said Camhs teams have been engaging with the Mental Health Commission over the independent review of services it announced last February.

Earlier this week, the Government opened a compensation scheme for the hundreds of children and families who suffered harm as a result of failings in mental health care in south Kerry, which is expected to cost tens of millions of euro.

The Irish Hospital Consultants’ Association (ICHA) said events in south Kerry had cruelly exposed the consequences of the resourcing crisis afflicting the health service.

"Vulnerable children who depend on our health service were badly let down," said IHCA president Prof Alan Irvine. "These children and their families needlessly suffered. They continue to pay a heavy price."

The Maskey report had highlighted how the absence of a permanent consultant in the services over five years had contributed to the failings that occurred, he pointed out.

According to the IHCA, 33 out of 114 permanent child and adolescent psychiatry posts at consultant level are unfilled in Camhs services across Ireland.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times