Child and Adult Mental Health Report

HSE publishes Second Annual Report on progress of the delivery of
Child and Adolescent Mental Health Services (CAMHS)

• 55 multi-disciplinary community Child and Adolescent Mental
Health Services teams in place providing care and treatment plans to
children and adolescents
• 7,651 new cases were seen by community CAMHS teams in the period
October 1st 2009 to September 30th 2010
• Of 7,651 new cases, 47% were seen within 1 month of referral and
69% within 3 months of referral
• In the first 9 months of 2010, the majority (63%) of young people
under 18 years of age, were admitted to Child and Adolescent Mental Health
units

Dr Frank Dolphin, Chairman of the HSE, today 23rd November 2010 launched
the Health Service Executive’s second annual report on Child and
Adolescent Mental Health Services (CAMHS). This report provides a
comprehensive update of the current stage of development of HSE’s CAMHS
services, as outlined in the “Vision for Change” policy. The annual report
provides vital data on: the number of new cases seen; waiting time to be
seen; and mental health problems presented by age and gender. In addition,
the report provides data on the admission of young people under the age of
18 years for inpatient treatment.

Most children and adolescents enjoy good mental health, but studies have
shown that 1 in 10 children and adolescents suffer from mental health
disorders severe enough to cause impairment. Mental health disorders in
childhood are also the most powerful predictor of mental health disorders
in adulthood. The publication of the second annual report means that the
HSE has the comprehensive information from which to monitor the mental
health of our young people and which will inform the development of
services which respond to their needs.

The expansion of Child and Adolescent Mental Health Services (CAMHS) teams
was one of the key recommendations of the 2006 strategy “A Vision for
Change”. CAMHS provide specialist mental health assessment and treatment
to young people by way of a multidisciplinary approach. A characteristic
of CAMHS teams is that they can draw on their multidisciplinary makeup to
undertake comprehensive and complex assessment and treatment approaches.
In addition, they can provide packages of care where more than one
professional or intervention is required in order to meet the needs of
young person and their family or carers.

Progress for 2009 captured for the CAMHS teams:

Treatment waiting lists decreasing
All community CAMHS teams screen children and adolescents referred to
their services on the basis of the urgency of need. Children and
adolescents in need of an urgent appointment are seen as a high priority.
A total of 7,651 new cases were seen by community CAMHS teams in the
period October 1st 2009 to September 30th 2010. Over this period 47% of
new cases were seen within 1 month of referral, 69% within 3 months. The
2009/2010 annual report indicates a downward trend in routine waiting
lists. A total of 2,370 children and adolescents were waiting to be seen
at the end of September 2010. This represented a decrease of 247 (9.5%)
from the total number waiting at the end of September 2009. 29 (58%)
community CAMHS teams had a waiting list of less than 50 cases, 14 (28%)
had a waiting list of 50 to 99 cases, 5 (10%) had a waiting list of 100 to
149 cases and 2 (4%) had a awaiting list of 150 to 199 cases.

Increase in staffing in CAMHS Teams
Specialist community Child and Adolescent Mental Health Service (CAMHS)
teams are the first line of specialist mental health services and provide
assessment and treatment to those children and young people with the most
severe and complex mental health disorders. There are now 50
multidisciplinary community CAMHS teams are in place, of the 50 community
teams, there has been an 8% increase in staffing in the last year, with a
staffing level of 456.11 whole time equivalents, which is 70.2% of the
recommended level for these teams. In addition, in Dublin there are 2
multidisciplinary teams providing day services and 3 hospital liaison
teams in each of the paediatric hospitals, with an additional 52 staff
allocated to these teams.

In-depth review of activity occurring in November 2009
For the second time, an in depth survey of all CAMHS activity happening in
Ireland during the month of November 2009 was captured. During the course
of November a total of 6,950 cases were seen by community CAMHS teams,
6,617 (89.5%) of these cases were returns and 733 (10.5%) were new cases.
12,147 appointments were offered, 10,192 appointments were attended, with
a resulting non attendance rate of 16.1%. Analysis of the data collected
indicated that:

• Adolescents aged 15 years are most likely to be attending
community CAMHS, followed by children aged 10 to 14 years.
• Adolescents aged 16/17 years constitute 13.4% of the cases
reflecting the practice of CAMHS teams keeping on open cases after their
16th birthday.
• The ADHD / hyperkinetic category (33.1%) was the most frequently
assigned primary presentation followed by the anxiety category which
accounted for 16.1%.
• The ADHD / hyperkinetic category peaked in the 4 to 9 years age
group at 45% of cases in this age group, dropping to 20.5% of adolescents
in the 15 to 17 year age group.
• Depressive disorders increased with age, accounting for 21.5% of
the 15 to 17 year age group.
• Deliberate self harm, which increased with age, accounts for 6.2%
of the primary presentations of the 15 to17 year age group age group,
however deliberate self harm / suicidal ideation was recorded as a reason
for referral in 22% of the new cases seen.
• Eating disorders increased with age, accounting for 5.6% of the
primary presentations of the 15 to 17 year age group.

In addition 345 young people were seen by the day service and hospital
liaison teams in November 2009

The report also provides in depth information on the admission of young
people for inpatient treatment. In the first 9 months of 2010 the majority
(63%) of young people were admitted to child and adolescent units. This
had increased from 42% in 2009 and reflects the increased child inpatient
capacity that is coming on stream, and with the imminent opening of 2 new
20 bed units at Cork and Galway this trend is expected to continue.

Dr Frank Dolphin, Chairman, HSE officially launches the report
Dr Frank Dolphin, Chairman of the HSE commented: “I am pleased to
officially launch the 2009 Second Annual Report of Child and Adolescent
Mental Health Services in Ireland, which provides us with detailed
information on how mental health services for our children and young
people are developing. Childhood is short and it is heartening to see the
major progress that is being achieved in the mental health services being
provided to children and young people. When a child is in difficulty,
early intervention by skilled professionals is vital. The commitment, care
and innovation displayed by the CAMHS teams in responding to the needs of
clients and families are particularly impressive. The focus on monitoring
and research will enable us to identify and respond to emergent issues and
trends and continue the ongoing development of our mental health services
for children and adolescents.”

The 2009 – 2010 Second Annual Report of Child and Adolescent Mental Health
Services is available to download at www.hse.ie