Mental health services

Sir, – It was very encouraging to read Paul Cullen’s article “Emergency department overcrowding: ‘People get left behind because there’s nobody at home’” (News, December 2nd) regarding St Luke’s Hospital, Kilkenny. The entire team, from general manager to all the front-line staff, are incredibly positive and energetic in the face of increasing demand and complexity.

The innovative ideas highlighted by my colleagues, Prof Garry Courtney and Dr Rory McGovern, combined with the massive increase in investment in recent years for both acute hospital services and older people’s community services, provide reassurance and hope.

However, it has also been demoralising to note the lack of proportionate investment in psychiatric services for the patients that I and other specialist psychiatrist colleagues treat and support.

The article highlights in particular several young people waiting for a child and adolescent mental health services (Camhs) assessment.

Joe Canning: Clare are in the last-chance saloon if this team is to win an All-Ireland

---

Seán Quinn’s former properties in Kyiv: The battle and the war

---

Floritz review: A glitzy but perplexing new restaurant with an overwhelming menu

---

South Dublin school’s plans to create ‘private Aviva’ in Rathgar square face local backlash

---

Camhs is a service funded to assess and treat patients with moderate to severe mental illness. The majority of children and adolescents who present to the acute hospital with mental health presentations do not have a psychiatric illness but have psychological distress. As such they do not need a Camhs assessment and should instead, in the first instance, be seen, assessed and managed through primary care psychology or disability services, or both. However, there is no access to these services while in an emergency department.

In addition, there is currently no funding for a liaison service between Camhs and primary care (despite national policy back in 2006 that recommended 13 liaison Camh teams be established nationally). Local Camhs teams provide temporary emergency cover during the working week to fill this gap, from within their own poorly staffed but highly motivated service. Indeed, Camhs in the southeast is the second-lowest resourced mental health service in the country, according to a recent Mental Health Commission report.

This is frustrating and disappointing. We are currently funding Ireland’s psychiatric services at less than 50 per cent of what is considered OECD norms – a depressing reality for which the HSE and Department of Health are accountable. The children of Ireland who need specialist Camhs support deserve far better. – Yours, etc,

Dr MIA McLAUGHLIN,

Chair,

Refocus Committee,

Consultant Psychiatrist,

Old Age Psychiatry,

College of Psychiatrists of Ireland,

Dublin 2.