CHO1 responds to CAMHS review report

Recruitment of a CAMHS Clinical Director and Practice Managers planned.

Several service improvement initiatives have commenced including a targeted Wait List initiative programme since a review was carried out of Child and Adolescent Mental Health Services locally.

The Mental Health Commission (MHC) this morning published individual reports into the provision of child and adolescent mental health services (CAMHS), flagging 21 challenges in this region specifically, along with six areas of concern that need to urgent addressing.

They include staffing issues, dysfunctional team work, failures to review and monitor clinical files, and “dilapidated” infrastructure.

As of March 2023, there were 447 potentially vulnerable young people awaiting access to services in CHO 1, which covers Sligo, Leitrim, Donegal, Cavan and Monaghan.

There are eight CAMHS teams in CHO 1- in Sligo, Leitrim, one each in South and North Donegal, Inishowen, Cavan, Monaghan, and also a Cavan/Monaghan Centre Team.

Addressing the contents of the report, the HSE says “from the onset” it has acknowledged that “significant improvements” are required in Community Healthcare Cavan, Donegal, Leitrim, Monaghan, Sligo (CH CDLMS), formerly known as CHO1.

Having invested regionally funded resources in the absence of national funding, they say: “We will continue to advocate for additional funding for our CAMHS teams through the annual national service planning process. All of the teams are experiencing an increase in the volume and complexity of referrals, with services under pressure as demand continues to exceed capacity. Additional recurring investment is required to build capacity to keep pace with the growing demands and increased complexities experienced by our CAMHS teams.”

The CH CDLMS Executive Management Team is meanwhile committed to “strengthening clinical governance” and has decided to progress with the recruitment of a CAMHS Clinical Director and Practice Managers as “key elements” of the service improvement plan subject to national approval.

“Where concerns were raised by the Inspector of Mental Health Services regarding specific service users, immediate actions were taken to seek and provide assurances to the MHC regarding the safety of those service users. An immediate review of the identified cases was undertaken by an external review team, under the stewardship of a senior and experienced lead clinician. Confirmation was provided to the MHC that the five cases identified were reviewed regularly by their CAMHS team during 2023, with follow-up appointments documented in their files. To provide additional assurances, an additional two hundred and ninety-one open files and twenty closed files were also reviewed by the lead clinician and the review team confirmed that they did not identify any young people whose care was found to be of serious concern. The MHC was provided with the findings of the external review and it is welcome that they have acknowledged this in their report.”

Several service improvement initiatives have commenced including a targeted Wait List initiative programme.

The current number of service users waiting for an initial assessment is 320 (July 31) compared to 447 (March 10), representing a reduction of 28%.

The number of service users waiting more than 12 months for an initial assessment is currently eight (June), compared to 34 (March), representing a reduction of 76%.

“There is a concentrated focus on team development with tailored CAMHS Risk Management Training and Individual Care Planning (ICP) provided to all CAMHS staff, with over seventy frontline staff attending a facilitated workshop, supporting cross fertilisation of learning and experience.”

The HSE spokesperson says: “Notwithstanding the progress made, we know there continue to be gaps and weaknesses in the current service, with work ongoing to expedite the recruitment of key frontline staff and to ensure that all teams and line managers are supported in building a culture of compassionate leadership across CAMHS with a focus on greater job satisfaction, enhanced staff wellbeing, job satisfaction, ultimately leading to enhanced quality of care for the service users.”

They conclude by saying: “We encourage anyone engaged with a CAMHS service to stay connected with their team and any parent or guardian with a concern or query about their child who is currently attending CAMHS should either contact their child’s team directly or call HSELive at 1800 700 700 who will take their details and arrange for someone from their CAMHS team to contact them if necessary.”

Read More: HERE.

See next week's newspaper for full report.