CAMHS National Audit
In April 2022, it was confirmed that a National Audit of all CAMHS services throughout the country would be conducted. This followed the shocking findings in the report of Dr. Sean Maskey upon completion of his Look-Back review of CAMHS cases in the South Kerry area.
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Independent review of the provision of CAMHS
Dr. Maskey’s report outlined severe deficits in the care given to many young people attending the service in South Kerry. 46 children were found to have suffered significant harm and a further 181 had been exposed to the risk of significant harm due to unreliable diagnoses, inappropriate prescriptions, poor monitoring of treatment and potential adverse effects.
Upon the publication of The Maskey Report, concerns were expressed as to whether similar concerns and risks existed in CAMHS in other parts of the country.
An Independent Review of the provision of Child and Adolescent Mental Health Services in the State was commenced by the Inspector of Mental Health Services.
In January 2023, the Inspector, Dr. Susan Finnerty, published an interim report having completed her reviews in 5 out of the 9 Community Healthcare Organisations. Her decision to issue the report before all reviews had been completed was due to severe concerns and consequent risks for some patients that were found across 5 of the 9 Community Healthcare CAMHS reviewed.
Dr. Finnerty expressed concerns regarding the risk to safety and wellbeing of children receiving mental health services, the management of that risk and the lack of clinical governance.
Many of the interim report findings compare directly with the awful experiences of children and families, as highlighted in the Maskey Report in South Kerry. The State needs to urgently fund the same resources that were made available in the South Kerry review. The damage being done to many children today, as we speak, may be irreversible.
Prescription and management of medication
There are no Irish guidelines in medication management for children and adolescents on antipsychotic medication.
The NICE (National Institute for Health and Care Excellence) Guidelines are accepted by consultant psychiatrists in CAMHS as an appropriate standard of care. These guidelines set out the monitoring required for antipsychotic medication.
Dr. Finnerty’s report found that some of the CAMHS teams, that were part of the National Audit, did not monitor to an acceptable standard. The report highlighted the safety repercussions for the children involved. Side effects of antipsychotic drugs include serious weight gain, increased blood pressure, sleepiness, dulled thoughts and galactorrhoea (production of breast milk).
The deficits in Medication Management are very similar to those identified in the Maskey Report. It is clear that a comprehensive look-back of all Community Healthcare Organizations is urgently needed.
The Interim report – scratching the surface
Any outside off-island overview of CAMHS is to be welcomed.
The Mental Health Commission went off-island to find international experts to review this awful situation. On behalf of our clients, we have also engaged an international team of experts to review the impact the acknowledged deficits in care have had on our clients.
One team alone had 140 children “lost to follow up” It is clear that this interim report is an urgent warning to those in charge, that the CAMHS system is in crisis, and any delay is further damaging lives.
The results of the interim report reflect an examination of only 10% of files across 45 of the 74 CAMHS teams nationally.
By their own admission, the Mental Health Commission has no power to enforce any action.
In 2017, the Mental Health Commission in it’s Annual Report outlined a number of serious concerns in relation to CAMHS and Adult Mental Health Services.
Mental health commission annual report 2017
The Chairman in his foreword stated:
“Reform of the 2001 Act is now urgently needed and the Commission urges that the Department of Health takes heed of our commentary in this area to ensure the provision and regulation of a modern mental health service in Ireland. If this does not happen Ireland will continue to provide a level of unsafe and substandard services, which are not aligned to best practice and breach the fundamental rights of a vulnerable group of people who require such services.”
During 2017, a number of areas of significant non-compliance were identified by the Commission including medication practices, maintenance of records and staffing.
The Commission also highlighted serious concerns in community CAMHS. The Inspector found that teams were inadequately staffed and noted a variation in waiting lists for CAMHS referrals and the provision of emergency cover.
The Commission had also developed templates that were widely circulated to be used as a useful “checklist” for services to self-assess. A template for Medication Management was one of those circulated.
The Inspector’s report outlined that the Commission had met with the management teams of CAMHS in all nine Community Healthcare Organisations to obtain oversight of the State’s services.
Considering the Interim Report published by the Mental Health Commission in January 2023, and indeed the alarming findings of the Maskey Report in 2022, it is clear that the situation has deteriorated from the already unsatisfactory position that the Commission highlighted in 2017. Many young people attending, and who previously attended the services, have been failed.
How can Coleman Legal help
At Coleman Legal LLP, we have a team of highly qualified solicitors and legal executives with extensive experience in medical misdiagnosis, mismanagement of medication, and deficits in care. We are available to speak to the parents of the affected children in addition to patients who are now 18 years of age or older that may have been impacted by the misdiagnosis on the part of this HSE employee
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