I firmly support the regulation of all mental health services, including community CAMHS, and I have been progressing priority legislation to underpin this regulation.
The Government recognises the importance of ensuring all mental health services, both inpatient and community, and both adult and child and adolescent, are fully registered, regulated, and inspected by the Mental Health Commission in its role as the independent regulator of mental health services.
Under the Mental Health Act 2001, the Mental Health Commission registers, inspects, and regulates all inpatient mental health services, including inpatient CAMHS. The current Mental Health Act 2001 does not include any provisions for the registration or regulation of community mental health services and therefore, it is not considered that the Act provides the necessary legal basis to expand the Commission’s regulatory remit.
The expansion of the Mental Health Commission’s role into regulating all community mental health services, including community CAMHS, is being addressed in the forthcoming Mental Health Bill. This new Bill is a complex and lengthy piece of legislation. It will provide the necessary legal underpinning to ensure that the Mental Health Commission can regulate all community services. Additionally, the Bill will overhaul the involuntary admission and detention process, modernise provisions related to consent to treatment, provide enhanced safeguards for people accessing inpatient treatment, and provide a new, discrete Part that relates exclusively to the care and treatment of children and young people.
Drafting of this Bill has been prioritised and it is now in its final months of drafting. It will be introduced to the Oireachtas in the summer legislative session, which begins in April.
Work also continues to improve CAMHS at service level. Year-on-year funding for mental health services increased by €74 million from €1.221 billion in Budget 2023 to nearly €1.3 billion in 2024, and with a strong focus on investing in child and youth mental health. This is the fourth consecutive year of an increase for mental health services, and highlights in real terms the importance this Government places on the mental health of those living in Ireland.
CAMHS receives €146.5 million in dedicated funding annually. In addition to this, approximately €110 million in funding is provided by the Government to community-based mental health organisations and NGOs each year to deliver supports and services. A significant proportion of this is dedicated to supporting young people. I recently announced a further €10 million in funding for mental health to support the delivery of clinical programmes and youth mental health. This again highlights the Government’s recognition of mental health as a central component to overall health, and to reform youth mental health care in line with the policies Sharing the Vision and Connecting for Life.
For the first time in the history of the State we now have a dedicated National Office for Child and Youth Mental Health in the HSE. This is a very significant development which I delivered and it will improve leadership, operational oversight, and management of all service delivery and improvements. Both a new HSE National Clinical Lead for Child and Youth Mental Health and a new HSE Assistant National Director for Child and Youth Mental Health have recently taken up post.
There continues to be growing demand for CAMHS across the country with over 22,000 referrals last year. Between 2020 and 2021, referral rates into CAMHS increased by 33%, while the number of new cases seen increased by 21%.
It is acknowledged that there is a variation of referral acceptance across CAMHS teams, and this is an area being prioritised by the HSE to help improve access to CAMHS and to address CAMHS waiting lists. The HSE is taking account of the recent Maskey and Mental Health Commission reports on CAMHS, and is currently finalising a Youth Mental Health Service Improvement Plan which will set out agreed actions for focused service improvement through identified, timely, and measurable actions.
All CAMHS teams have worked closely with the Mental Health Commission over the last year or so to develop and implement improvement plans as needed following the Interim and Final Reports of he Commission on CAMHS nationally.
In addition, the HSE continues to progress three national audits in relation to CAMHS arising from the Maskey Report on South Kerry. These were the national review of CAMHS prescribing practice and the national audit of compliance with the CAMHS Operational Guidelines, both of which were recently published. In addition, a qualitative review of service user experiences is being undertaken by UCC. These reports will be given full and proper consideration by the Government.
There are 75 CAMHS teams and 4 in-patient units nationally. Staffing in community CAMHS has increased in recent years, with an increase of 500 full time equivalent posts between 2011 and 2024. I secured funding for additional new posts under Budget 2024, with a focus on child and youth mental health posts.
CAMHS is a specialist service and can only accept children or adolescents where there is evidence of a moderate to severe mental health difficulty present. Access to CAMHS is detailed in the HSE Clinical Operational Guidelines which sets out the core functions and remit of CAMHS and indicates referral pathways to this specialist service. As such, CAMHS is not suitable for children or adolescents whose difficulties primarily are related to learning problems, social problems, behavioural problems, or mild mental health difficulties.
Evidence shows that only 2% of children and young people need the support of the specialist CAMHS multidisciplinary teams. Access is on the basis of prioritised clinical assessment and all referrals to CAMHS are assessed by a multidisciplinary team.
It is important to state that there continues to be growing demand for CAMHS, with the 75 community teams nationally delivering around 225,000 appointments for children and young people annually. The expected activity under the HSE National Service Plan 2024 projects CAMHS referrals received of approximately 23,000, with around 13,700 of these referrals expected to be seen by CAMHS in line with operational guidelines. CAMHS teams, along with the wide range of other youth mental health supports provided by or on behalf of the HSE, make a crucial and real difference to the lives of many vulnerable young people, and their families, each year.
The Deputy can rest assured that I, and the Government, remain fully committed to the development of all aspects of mental health services nationally.
