Of the 49 recommendations made by the Mental Health Commission in their Child and Adolescent Mental Health Service (CAMHS) report, the HSE have reported that approximately 40 of the 45 recommendations that fall under their remit are in progress. A number of these recommendations also relate to new service developments which are dependent on further investment.
Responsibility for 4 recommendations lie with the Department of Health.
Recommendation one, made by the Mental Health Commission, recommends the immediate and independent regulation of CAMHS by the Mental Health Commission, and that regulation must be put in place to ensure that all children have access to evidence-based and safe services, regardless of geographical location or ability to pay. 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.
Recommendation 2 relates to the implementation of these recommendations must be monitored by the Mental Health Commission who must publish a yearly report on progress of implementation.
My Department recognises that the Mental Health Commission play a vital role in the independent monitoring of mental health services in Ireland. The Department of Health welcomes the Commission’s focus on service improvement in CAMH services, particularly on foot of this report, however it is the role of the Department of Health to ensure that key performance metrics for HSE services are met, that investment is used for agreed service developments, and that policy recommendations are reviewed and enacted as appropriate. The functions of the Commission, as set out in section 33 of the Mental Health Act, do not include a function to oversee or monitor the performance of the HSE outside of services registered as approved centres nor do they grant an implementation function on the Commission. It is for the Minister and Department to either accept or not accept the recommendations arising from the Inspector’s report and for the Minister and Department to set any targets or goals for the implementation of any such recommendations, in consultation with the HSE and the Commission as appropriate.
The Department of Health has a key role in policy development, service development, and performance management. Officials in the Department of Health meet with senior HSE executives every month in the context of performance monitoring. A standing item on the performance agenda is child and adolescent mental health services (CAMHS), as well as progression and publication of the HSE audits arising from the Maskey Report. The Department have reviewed the 49 recommendations and in collaboration with the HSE continue to progress the recommendations from this report as part of engagements and performance meetings as deemed appropriate.
