10% of youth wait year for mental services

ALMOST A fifth of children and adolescents with mental health problems have to wait more than six months to see a mental health…

ALMOST A fifth of children and adolescents with mental health problems have to wait more than six months to see a mental health professional, a new report shows.

In the year to September, 7,651 new cases were seen by the 55 HSE community child and adolescent mental health teams across the country.

All cases are screened on the basis of urgent need. Some 47 per cent of new cases were seen within one month; 22 per cent within three months; 12 per cent between three and six months; and 9 per cent between six and 12 months. Ten per cent had waited more than a year.

The HSE’s annual report of child and adolescent mental health services also shows the number of children on HSE waiting lists on September 30th, 2010, fell by 9.5 per cent to 2,370 compared to the previous year.

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Some 396 children (17 per cent) on waiting lists had waited more than 12 months, and 610 children (26 per cent) had waited between six and 12 months.

HSE South and HSE West have the longest waiting lists, with more than a quarter of children and adolescents waiting more than a year for an appointment.

The report says staffing in the child mental health area has increased by 8 per cent this year. However, it warns "significant additional resources" will need to be invested in services to meet targets set in A Vision For Change, the Government's strategy for mental health services, which was published in 2006.

An in-depth review of 6,950 cases seen during November 2009 found fears of self-harm or suicide was recorded as a reason for referral in 22 per cent of the new cases seen.

The top five reasons for referral for all under 18-year-olds are: attention disorders, 33.1 per cent; anxiety disorders, 16.1 per cent; autistic spectrum disorders, 10.7 per cent; depressive disorders, 8.8 per cent; and behavioural problems, 8.6 per cent.

In the 15- to 17-year-old age group, deliberate self-harm accounted for 6.2 per cent of presentations, while eating disorders accounted for 5.6 per cent of presentations.

The vast majority of the 6,950 cases in the one-month survey involved children or adolescents who had already been seen by the child and adolescent mental health service. Just 10 per cent were new cases. Those most commonly seeking help were in the 15-year-old bracket, followed by children aged between 10 and 14.

Boys accounted for 67.9 per cent of all cases presenting to the mental health services.

The goal of A Vision For Changeis to establish 99 community teams across the country and recommend staffing levels across all mental health services.

The HSE report says “significant additional resources” are needed, and systematic national and regional planning is necessary to provide trained personnel and infrastructure.

The report estimates that the decision to extend child and adolescent services from 16 to 18 years “doubles the cost of providing the service”.

In 2009 there were 367 admissions of children to in-patient units; 58 per cent of admissions were to adult inpatient units. No child under 16 years of age should be admitted to adult units under a new code of practice. Next week this code will extend to all children under 17 years.

The report shows staffing levels have increased by 8 per cent this year to 456 full-time positions. This is 70 per cent of the recommended level in A Vision For Change.

The report was published yesterday by HSE chairman Dr Frank Dolphin at the launch of a 20-bed child and adolescent mental health services inpatient unit in Galway costing €8.8 million.

Amnesty International said the report uncovered a bleak reality for young people accessing mental health services in Ireland due to “long waiting lists, inadequate facilities and limited treatment options”.

Child mental health services

Main reason for referral:

Attention disorders 33.1%

Anxiety disorders 16.1%

Autistic spectrum disorders 10.7%

Depressive disorders 8.8%

Behavioural problems 8.6%

Eating disorders 2.8%

Deliberate self-harm 2.7%

Development disorders 2.6%

Psychotic disorder (schizophrenia) 1.1%

Substance abuse 0.8%

Gender role/identity disorder 0.2%

Habit disorders (soiling/tics) 1.2%

Others/not defined/ more than one 11.3%

Source: Second Annual Child Adolescent Mental Health Report 2009-2010 (HSE)