Access to mental health services for young people ‘severely inadequate’

Some doctors are still talking over the heads of children and young people who are experiencing severe mental health issues, addressing parents instead and using language that the patient cannot understand.

That is according to the Ombudsman for Children Niall Muldoon, who will present research based on the experience of children and young people at in-patient mental health units, to the Annual Conference of the Psychological Society of Ireland this week.

Mr Muldoon who is also a psychologist, will tell the conference in Wexford that the process of helping children and young people with mental health difficulties is “a severely inadequate system”.

Speaking to The Irish Times in advance of the conference, Mr Muldoon said many GPs are medicating young people who have severe mental health issues, either because of a lack of understanding, or because waiting times to see a psychologist are too long.

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Mr Muldoon said the research revolves around a consultation the Ombudsman for Children’s Office set up with young people who were receiving mental health care and treatment, in five of the State’s six in-patient mental health units in 2017.

The research project, entitled, “Take my hand – listening to the voices of young people in inpatient mental health units” was carried out by Mr Muldoon and researcher Naomi Keenan.

Based on young people’s experience of first engagement with mental health services, and their transition through the system to inpatient care, the research was designed to “provide psychologists with an insight into how young people believe services can be improved”, Mr Muldoon said.

Many of the 14- to 17-year-olds interviewed reported GP referrals had featured clinicians speaking to parents, using language the young people did not fully understand. “I thought that was gone,” Mr Muldoon said.

Mr Muldoon said the HSE’s Child and Adolescent Mental Health Services, CAMHS was supposed to be the last line, after the GP and then referral to a local psychologist or therapist. But for those really struggling, who are referred to CAMHS, it can mean a long wait – up to 18 months in some parts of the country.

Participants in inpatient units were asked what had been helpful, what had been challenging and what changes would they like to see made to mental-health services for young people.

“We wanted to talk about their journey, from the first time they looked for help with their mental health,” said Mr Muldoon. The response was that many would have much preferred the primary-care services to have helped them more. While participants said the input of family was very positive, Mr Muldoon said the process can see them out of school for a year. Going back to repeat a year and explaining where they have been to peers was difficult, Mr Muldoon said, adding that teachers and principals also need support and education when dealing with such cases.

“You often find GPs are carrying children with a lot of pain and can’t get them in anywhere”, he said. This often left GPs in the position that they felt they needed to prescribe medication while the patient is waiting for an appointment.

Distance is also a factor, he said, with no inpatient unit north of a line from Dublin to Galway. This could potentially deprive patients of some family supports.