The Irish Times view on mental health services: unacceptable failures

A review of child mental health services in south Kerry found that hundreds of children received “risky” treatment

Taoiseach Micheál Martin described the review of cases at the the HSE-run South Kerry Child and Adolescent Mental Health Service (as “very, very serious” and “unacceptable”. Photograph: Julien Behal/PA Wire

The review into allegations that young people were given inappropriate medication at a State mental health service in Co Kerry raises serious questions that go beyond any one doctor or region. The examination of case files from the South Kerry Child and Adolescent Mental Health Services (Camhs) over a four-year period found that hundreds of children received “risky” treatment from a doctor and that significant harm was caused to 46 of them. That harm included the production of breast milk, excessive weight gain, sleepiness during the day and raised blood pressure.

The report found that the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) for secondary-school children was often made without enough information from their teachers, and there was evidence of “inconsistent and inadequate” monitoring of adverse effects of medication. The report concluded that it was a “reasonable assumption” that the doctor was intending to help, not harm, the patients and that the exposure to risks and harm were the result of a lack of knowledge about good practice.

But the issue is wider than any one individual. The report found that 13 children were unnecessarily exposed to the risk of harm under the care of other doctors in the service. More broadly, it identified gaps and failings in how the services were run and overseen. Having a doctor give the wrong medication to children is one thing; having a system that cannot identify the problem and stop it is quite another. In the service where the doctor worked, there was no clinical lead and no consultant child psychiatrist. Concerns about the doctor were first reported in 2018, but no proof was found that these concerns were addressed. The doctor was seen to be very tired at work, but this issue was also left unaddressed.

Many parents will quite reasonably ask whether, if it happened in Co Kerry, could it happen elsewhere as well. Apologies are fine, but the only worthwhile form of reassurance is to ensure the report’s 35 recommendations are implemented without delay.