Unfilled psychiatric posts leaving young people on ‘unacceptably long waiting lists’

In child and adolescent psychiatry, more than one-third of approved permanent consultant posts either vacant or filled on a temporary basis at end of 2023

More than one-third of psychiatrist posts in the Child and Adolescent Mental Health Services (Camhs) are not permanently filled, according to new data.

The Irish Hospital Consultants’ Association (IHCA) said unfilled posts, combined with “growing hospital and mental health capacity deficits against increases in demand” are the causes behind the “unacceptably long waiting lists”.

New figures, released to the IHCA under the Freedom of Information laws, show 156 (28 per cent) of the 548 approved permanent consultant psychiatry posts in Ireland were either vacant or filled on a temporary or agency basis on March 1st.

This consisted of 52 vacant posts, 28 posts filled by agency staff, a further 74 posts filled on a temporary or locum basis and two posts of “unknown” status.

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In child and adolescent psychiatry, more than one-third of approved permanent consultant posts (44 posts or 35 per cent) were either vacant or filled on a temporary basis at the end of 2023.

Latest figures from the Department of Health confirm that there were 3,759 children on the Camhs waiting lists at the end of last year.

While it is a reduction on the record high of 4,400 young people on the waiting list, it is almost two-thirds (or 62 per cent) higher when compared to pre-pandemic levels at the start of 2020.

Dr Elaine Lockhart, chair of the Royal College of Psychiatrists Child and Adolescent Faculty based in Scotland, said post-Covid there had been a surge in referrals to mental health services, and an increase in very sick young people, particularly those with eating disorders, self-harm and suicidality.

“What we were seeing before Covid was an increase in social inequality which can be toxic for children’s mental health. And although social media can be a real force for good, vulnerable children can be really harmed by being online. So, things were getting worse before Covid,” she said in a video as part of the IHCA’s Care Can’t Wait campaign.

“But then the lockdowns really removed children from their usual routine, structure and predictability. They couldn’t meet friends and access activities and that triggered quite an increase in those seeking care. That was something we hadn’t seen before.”

Dr Lockhart, who studied in UCD, said children and young people needed better access to mental health services, particularly within their own communities.

“While specialist mental health services must be in place for those who are most unwell, what many children are looking for and require is access to services where they can get advice in schools and community settings,” she added.

A spokeswoman for the Health Service Executive previously said “Every effort is made to prioritise urgent referrals so that young people with high-risk presentations are seen as soon as possible. This is often within 24-48 hours. This may impact on wait times for cases that are considered, by a clinician, to be less severe.

“As of the end of August 2023, 56 per cent of referrals accepted by child and adolescent community teams nationally were offered an appointment within 12 weeks against a target of 78 per cent.”

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