RTE Big Picture - Youth Mental Health/CAMHS

The Black Oil

This was a damning documentary. Thanks to the families and young people who spoke out. I wish I could say I was surprised. A lot more clinicians are needed.

And of course, no HSE rep in studio to respond.

Freedive Ireland

Unfortunately a lot more to come in both in CAMHS and adult I think. Very courageous of the participants.

The Black Oil

Hmm!

https://twitter.com/DrJohnHillery/status/989981020987494400

Freedive Ireland

The imbalance of bio vrs psycho/social is appalling.

The Black Oil

Things in Wexford are imploding.

https://www.rte.ie/news/politics/2018/0613/970285-mental-health/

https://twitter.com/newsworthy_ie/status/1006966028860051458

The Black Oil

The Mental Health Commission's report yesterday got a decent bit of coverage. Wish I could say I was surprised at the findings - "marked deterioration since 2016". This is very disappointing for people who need to access and are in services.

https://www.rte.ie/news/ireland/2018/0725/980881-mental-health-commission/

Freedive Ireland

The Black Oil wrote: »

The Mental Health Commission's report yesterday got a decent bit of coverage. Wish I could say I was surprised at the findings - "marked deterioration since 2016". This is very disappointing for people who need to access and are in services.

https://www.rte.ie/news/ireland/2018/0725/980881-mental-health-commission/

The hse has so many policies no one really actually reads them. The culture is changing but in mm when it needs to be in km.

The Black Oil

Sigh.

https://twitter.com/MHReform/status/1022476676054347776

The Black Oil

And more.

https://twitter.com/Cooganlab/status/1075660575768743936

The Black Oil

RTE report this morning about the shortage (unsurprising) https://www.rte.ie/news/2019/0131/1026756-shortage-of-paediatric-psychiatrists-hse-figures-show/

The Health Service Executive has revealed that only half of all specialist paediatric psychiatry posts advertised in the last two years have been filled.

Figures obtained by RTÉ News under Freedom of Information show that there is currently a shortage of consultant psychiatrists with a specialism in Child and Adolescent Mental Health.

The HSE said the posts remain unfilled due to a lack of appropriate qualifications or because candidates withdraw from the recruitment process or refuse the post.

There are currently 29 vacant posts for child and adolescent psychiatrists across the country.

And also, the PSI issued a good statement a few weeks ago too. In essence, that best practice coming first should be more so the case than psychiatry. Now, can we do that?

There has been much media focus in recent years, and indeed months, on the difficulty in recruiting Consultant Psychiatrists for Community Mental Health Teams (CMHTs). Consultant Psychiatrists have an important role as one of the core multidisciplinary team, delivering care in CMHTs.

However, the inferences have been that the absence of a Consultant Psychiatrist being available on a CMHT precludes the safe and effective work of all other disciplines.
The legal and contractual rational for psychiatry automatically assuming the role of “clinical lead” is questionable.

~

The PSI strongly asserts that, in moving forward with quality mental health care in Ireland, it is essential that the concepts of leadership and clinical leadership in mental health are brought into line with international best practice.

Consequently, the PSI recommends the development of a competency framework for clinical leadership and leadership development programmes that are equally open to all suitable clinicians with the requisite competencies.

The Black Oil

Guidance counsellors is a topic that comes up now and then, due to students at risk and cutbacks, etc. They've frontline contact with students and yet...

Irish Times

Guidance counsellors say they are struggling to cope with an “epidemic” of anxiety among secondary school pupils. Speaking at the annual conference of the Institute of Guidance Counsellors, president Beatrice Dooley said demand for support was on the rise for issues such as anxiety, self-harm or suicidal ideation. However, she said guidance counsellors were under acute pressure and called for an immediate reversal of austerity-era cuts to the sector. “On the ground our members are overstretched. I spoke this week to a colleague from a town where five schools are struggling to cope with a spate of copycat suicides,” Ms Dooley said. “What is the solution? When a student takes their own life, the guidance counsellor is left to deal with the considerable cohort of students who present at our office in the succeeding few days. “These students are now terrified as they too have experienced suicidal ideation and they are highly stressed that they could go take that final step. It is overwhelming.

Troubling too that some of the work is coming from those not qualified.

On another note.

https://twitter.com/lisabdixon/status/1114636541727580160

SuperRabbit

When they gave them a follow up call did they also offer them help if the person said they needed it? Or was it the calls themselves?

Samaritans do work with schools.

https://www.samaritans.org/ireland/how-we-can-help/schools/

It would have been great if teachers in my school had had that kind of training, they never listened to students and if you were being bullied you'd just be given loads of terrible advice, be told it was your fault for not fitting in and be given fashion tips. Basic human concern and a few hours training in active listening would have saved lives and a lot of pain, I feel really sure of it.

Someone in my class lost a parent to suicide and it was never discussed. It was announced to us all on a Monday morning in the middle of a long list of housekeeping things, then never mentioned again. Same when a girl in our year died by suicide.

Of course it would be better if the government would directly fund, or if professionals would volunteer, to do this as well. But considering how clueless a lot of schools are this is still an excellent resource with a long track record in the UK.

On the ground our members are overstretched. I spoke this week to a colleague from a town where five schools are struggling to cope with a spate of copycat suicides,”

Relevant:
https://www.samaritans.org/ireland/how-we-can-help/schools/step-step/

The Black Oil

More psychologists? Yes, Minister, we could do with that.

https://twitter.com/PsychSocIreland/status/1138042095292342272

The Black Oil

This is a good piece outlining one young woman's experiences and the wider CAMHS situation. https://www.irishtimes.com/life-and-style/health-family/when-i-was-16-everything-was-fine-then-suddenly-it-wasn-t-1.3924611

The Black Oil

Preach

https://twitter.com/psychpolis/status/1151632758520909824

The Black Oil

Government: Let's do something on youth mental health.
Government: A task force, that's it!
Public/clinicians: Story lads. Any update on this?
HSE/Government: *crickets*

https://twitter.com/psychpolis/status/1162700014956793857

The Black Oil

Must be incredibly frustrating for GPs and a real slap in the face for families too.

https://twitter.com/drwilliamlynch/status/1186223443727048704

https://twitter.com/LuciaGannon/status/1192786049354911747

The Black Oil

Also btw, what the heck is up with 'psychiatric' in the second letter being in italics? Is it just style thing or was it to sell the PFO vibe?

Such a broken system.

Freedive Ireland

if meds aren't required then you just aren't sick enough. I'd guess 99% of service users in MH services are on meds and if they are not they are soon discharged. Evidence based indeed.

The Black Oil

Get on with it, government.

https://twitter.com/serentrippety/status/1200028047270981637

The Black Oil

Hope they keep the pressure on.

https://twitter.com/PsychSocIreland/status/1201471084488527875
https://twitter.com/AOTInews/status/1200915285554929665

The Black Oil

Spare a thought or two for the young people who are in CAMHS inpatient units at this time of year.

At Christmas, children’s wards and hospitals are inundated with gifts—from the public, community organisations, and private companies. Yet, some children who are in hospital over Christmas, are not in children’s wards or children’s hospitals, but in child and adolescent mental health services (CAMHS) inpatient units. They are often admitted far from home, and sometimes detained in hospital under a section of the Mental Health Act for their own safety or wellbeing. Some are just too unwell to be allowed home over Christmas, and need intensive support from CAMHS staff. The festive period can be particularly difficult for some children in mental health units—eating disorders can worsen given the association of Christmas with food, and for those without stable family relationships, the emphasis on family at this time of year can be a cause of distress.

CAMHS units rarely receive donations of Christmas gifts; and if they do, it’s a tiny proportion of those received by children’s wards in acute hospitals.

I first wondered about this discrepancy after I spent two Christmases as a junior doctor in different children’s hospitals, and saw the enormous amounts of gifts donated. One hospital still had leftover gifts in June! (They were used for inpatients’ birthdays.) Yet the following year, working in an adolescent mental health unit, I found myself wondering where the donated gifts were. I realised there weren’t going to be any. I saw the occupational therapists concerted efforts to spend the unit’s allocated £10 per child, from the therapeutic activity/OT budget, on suitable presents for each inpatient, knowing how unlikely it was that acute children’s wards would have to do that. I was frustrated at what felt like public neglect of my adolescent inpatients, and raised it on social media, asking what were the reasons for this contrast with medical wards. To my surprise, it struck a chord with others, many of whom had never realised that children were inpatients in CAMHS over Christmas.

The disparity in the number of gifts received may simply be due to a lack of awareness that children are in mental health units over Christmas. This is despite the fact that young people’s mental health and insufficient provision of services and rising demand have been highlighted in the media. Perhaps it is because this coverage largely focuses on milder, more easily understood conditions, like stress and anxiety, or bullying and exam worries, and neglects the more severe issues of self-harm, suicide attempts, or young people who have experienced trauma, or who have psychosis.

https://blogs.bmj.com/bmj/2019/12/20/rosanna-bevan-the-forgotten-children-at-christmas/

SuperRabbit

Wow, what on earth. Wouldn't you think it was obvious anyone donating a gift to a children's hospital wants it to go to any child in hospital at christmas and has no idea that they themselves are expected to know what unit to give it to!? Very disorganized HSE as usual

The disparity in the number of gifts received may simply be due to a lack of awareness that children are in mental health units over Christmas.

absolutely not, people just don't realize that these children are segregated to the point where they not given the gifts, it's still the HSE after all, what on earth? Why aren't they given the donated gifts which are obviously intended for them as well? The public are supposed to know the ins and outs of HSE wards?

rabble rabble rabble rabble!

The Black Oil

This was predicted a while ago. Disappointing. :mad:

https://twitter.com/juneshannon/status/1230045963315748864

The Black Oil

153 staff for 2021 for CMHTs, including 29 for CAMHS. We'll see.

https://twitter.com/MaryButlerTD/status/1336710592443379713
https://twitter.com/MaryButlerTD/status/1336726232533241859

Gremlinertia

Recruit from who? I don't know where the people will come from this..

The Black Oil

Gremlinertia wrote: »

Recruit from who? I don't know where the people will come from this..

Lord knows given that therapists have been redeployed during Covid...

The Black Oil

Welcome to Ireland where we haven't a clue.

https://twitter.com/psychpolis/status/1357415466466172932

The Black Oil

https://www.thejournal.ie/hse-bed-closures-camhs-dublin-linn-dara-5770237-May2022/

Really disappointing.

Humria

I was just looking at the Psychology forum and saw this thread. It reminded me of the South Kerry CAMHS review. The whole review was completed by Psychiatry, Nursing and Clerical staff. The lack of representation of multi disciplinary staff was noticeable. On the ground level, staff I have worked with have noted that the lack of resources in Primary Care Psychology has a huge knock on to CAMHS but none of that appears to be acknowledged. The primary recommendation is that there needs to be a Consultant Psychiatrist. There are many CAMHS teams in the NHS headed by Psychology, it does not actually need to be Psychiatry. In my experience the higher management in CAMHS are medics or influenced by medics. The response we have gotten to the lack of Psychology in some areas it that it's fine because we can upskill nursing. I have worked with some excellent nurses but they are not qualified Psychologists. There has been huge input into Advanced Nurse Practitioner posts but a statement that they cannot afford more Occupational Therapists or Social Workers. I think CAMHS staff on the ground work really hard, aim and really aim to provide a good service. The management priorities and structures can be a bit depressing at times though.