Dáil Éireann Debate, Wednesday - 17 January 2024
1519. Deputy Colm Burke asked the Minister for Health if he will review the operation of CAMHS in line with Mental Health Commission recommendations, noting that the current model of care places the onus on a single professional; if he will consider a more multi-disciplinary approach in line with other European countries; and if he will make a statement on the matter. [56628/23]
View answerThe Mental Health Commission final report on Child and Adolescent Mental Health Services (CAMHS) in the State was a welcome contribution to a common objective of improving CAMHS services. Of the 49 Recommendations, many are already being progressed under workstreams arising from the Sharing the Vision Implementation Plan, the Maskey Report, the HSE CAMHS Clinical Operating Guideline (COG) audit and the HSE national audit of prescribing practice. Publication of the HSE CAMHS COG audit is imminent and will offer an insight into the multidisciplinary practices across teams nationally. The purpose of the HSE CAMHS COG is to provide consistency in the service delivery of CAMHS throughout the country. This Operational Guideline applies to all staff engaged in the delivery of CAMHS by, or on behalf of, the HSE in Community and Inpatient settings and ensures a multidisciplinary focus on service delivery. Each CAMHS team has clear accountability structures in place to achieve the delivery of high-quality, safe and reliable services. The Consultant Psychiatrist is the Clinical Lead on the team. Each member of the CAMHS team also has a professional and management reporting relationship through their discipline-specific line management structure. Each member of a CAMHS team has the professional responsibility to carry out clinical work with children and adolescents within their scope of practice, as defined by their professional and regulatory bodies such as the Medical Council, the Health and Social Care Professionals Council (CORU), the Nursing and Midwifery Board of Ireland (NMBI) and the Psychological Society of Ireland (PSI). Each individual CAMHS team member knows their responsibility, level of authority and to whom they are accountable.
The Mental Health Commission plays a vital independent role in supporting and assisting the Department of Health and the HSE in developing and improving mental health services. Both I and the HSE share the Commission’s commitment to ensure the safest and most effective service for children. To this end, on foot of the Maskey report I had extensive engagement with the Commission and encouraged them to undertake a comprehensive review of children’s mental health services as the topic for their annual mental health services review. I was also pleased to offer the necessary resources to the Mental Health Commission to enable this comprehensive review to take place, running in parallel with the HSE national CAMHS audits.
While the Mental Health Commission Interim Report highlighted concerns regarding service delivery and administrative practices in five CHOs, many of these related to operational issues within CAMHS teams that have been recognised and resolved. It is reassuring that the final report identified evidence of clinical audits of open cases during the review of the final four CHOs. This final report, along with the interim report, highlight concerns regarding gaps in governance at corporate and clinical level across CHOs. In highlighting these areas where practices can, and should, be addressed, the Commission provides an opportunity to ensure that the HSE’s services are improved, including a commitment to a multidisciplinary model of care and support.
In addition, the recognition of the need to strengthen the leadership and multidisciplinary focus on CAMHS is evidenced by the establishment of a new Child and Youth Mental Health Office in the HSE and the recent appointments of an Assistant National Director for Child and Youth Mental Health and a Clinical Lead for Child and Youth Mental Health. I believe these recent appointments in senior leadership roles within mental health will further strengthen the national leadership across our mental health services to support all CAMHS practitioners.
The Department of Health looks forward to working with the HSE in the implementation of the Child and Youth Mental Health Service Improvement Programme, which is an initiative to build capacity in CAMHS and Youth Mental Health. The initiative, aims to make services more responsive by recruiting additional expert staff, expanding teams, developing specialist services and clinical programmes and further developing suicide prevention initiatives and primary care mental health services.
I look forward to continuing to engage with the HSE, and specifically with the new office for youth mental health, to ensure that our CAMH services are continually improved with a strong focus on consolidation of the multidisciplinary team and a multidisciplinary model of care.
