Sir, – I am surprised that the message Prof Mac MacLachlan takes from the Maskey report into Child and Adolescent Mental Health Services (Camhs) in south Kerry is that there was too much rather than too little senior psychiatric leadership (“Mental health services must be prised from grip of psychiatry”, Opinion & Analysis, May 22nd).
The consultant psychiatrist has the extensive professional training and clinical expertise needed to provide leadership within mental health teams. We are skilled and experienced in managing psychiatric emergencies, including working out-of-hours on on-call rotas, we have specific statutory roles under the Mental Health Act, and are the professionals who find themselves answering to the courts when things go wrong.
The experience of other jurisdictions is that other healthcare professionals do not have the expertise and do not want to take on the significant clinical and medico-legal responsibilities incumbent in the role of clinical lead for a mental health team.
Prof MacLachlan seeks to denigrate the value of psychiatric medication and role of diagnosis in the treatment of mental illness but this is in fact the most effective intervention for serious mental illness such as psychosis and mania, and it is highly effective for many other conditions, including ADHD. Diagnosis is central to the use of medication and remains the domain of the medical specialist in mental illness, the psychiatrist.
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Squabbling over psychiatric leadership is a distraction from the root cause of our current difficulties, chronic and severe underfunding of mental health services in both primary and secondary care. – Yours, etc,
Dr PAUL MATTHEWS,
Consultant General
Adult Psychiatrist,
Celbridge,
Co Kildare.