Sir, – We agree with our specialist colleagues, in their letter of January 28th, about the crisis in child and adolescent mental health services and that mental illness should be afforded the same level of importance as physical illness. Our current services, especially for children and families living in disadvantaged communities, where prevalence of mental illness is much higher, are not fit for purpose. Services for children that have waiting lists of 18 months or more are pointless, given the dynamic nature of their growth and development and early adverse experiences have lifelong impact on both mental and physical health. What is needed is an integrated care system that resources general practice and primary care where the majority of children and adolescents with mental health presentations can be managed. GPs can work with specialist colleagues to identify clear, appropriate and timely referral pathways for specialist care when needed.
Rather than delay reform with another audit, we agree that urgent action is needed to reform a system that is damaging children and adults. GPs are the first port of call for most children with mental health problems. We agree that transformative change is urgently needed but this needs to involve a collaborative effort between GPs, specialist child psychiatrists and other mental health disciplines. – Yours, etc,
Prof SUSAN SMITH,
Dublin 8;
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Dr ANNA BEUG,
Dublin 8;
Dr EDEL McGINNITY,
Dublin 15;
Dr MARY FAVIER,
Cork City;
Dr KIERAN COLEMAN,
Galway City;
Dr DAVID GIBNEY,
Dublin 9;
Dr NIAMH O’BRIEN,
Galway City;
Dr ANNA MARIE
NAUGHTON,
Cork City;
Dr MUIREANN O’SHEA,
Dublin 24;
Dr VIVIENNE WALLACE,
Dublin 5;
Dr EOIN MONAGHAN,
Cork City;
Dr BRID SHANAHAN,
Dublin 1,
(On behalf of Deep End Ireland, a group of general practitioners working in the most disadvantaged communities in Ireland).