The Irish Times view on the report on Camhs: a service creaking at the seams

It is telling that the deeply worrying report on the Child and Adolescent Mental Health Services (Camhs) published yesterday comes as little surprise. The report, by Dr Susan Finnerty, the chief inspector of mental health services, follows an interim report earlier in the year, and many stories from families of the difficulty of accessing services. The writing has been on the wall for a long time now and the report calls clearly for action to be taken.

Its conclusions could hardly be more stark. Families cannot be assured that the HSE services are “safe, effective and evidence based”, it warns. The system is “creaking at the seams”, creating risks for children and deep frustration for families. It is understaffed and, in many cases, poorly managed, moving from one crisis to the next without any apparent wider strategy.

The review by Dr Finnerty follows a report last year on the south Kerry Camhs, which found 240 children received substandard care and 46 were harmed. It is clear now that the failings in the service were not localised, but go across the nine Community Health Organisations (CHOs).

Many staff work extremely hard, the report says, and many young people have received excellent care. But Dr Finnerty says bluntly that she cannot give an assurance to all parents and guardians of access to a safe and effective service. Many young people, in other words, are failed by the State in this vital area.

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Lack of resources is clearly a problem, with the vast majority of teams understaffed and burnt out, and shortages, in particular, of consultant psychiatrists.

However, the problems go much deeper. There are significant and unacceptable variations in care across different areas of the country, creating a “postcode lottery for children and their families”. There are notable departures from good practice including deficits in risk management, a complete lack of follow-up on patients in some cases and long waiting lists. This leads to huge frustrations among families wanting to access services and creates risks to patients.

Some of this is down to resources and the traditional lack of adequate financial provision for mental health services generally and those for younger people in particular. HSE management is heavily criticised for clinging to “old models of service provision” which differ from those in place elsewhere and are not fit for purpose.

The Government must accept the report’s call for regulation of the service by the Mental Health Commission, ensuring it can oversee service provision. Resourcing must be immediately improved. And the HSE management of this service needs to be overhauled. Camhs does not so much need to be reformed as to be rebuilt; the Government faces many demands on its time and resources, but this must surely be a priority.